Marin Family Counseling

Q&A with Debra: What is Causing a Change in My Child's Sleep Pattern and Behavior?

Question:

My first-grader got off to a great start this year and seems really "in sync" with her teacher. However, over the past week I've noticed a change in her sleeping pattern. She has been waking up within an hour of going to bed and then seeks out her dad and me.

Then, last Friday, we got a call from the school health office that she came in and told the nurse she wasn't feeling well and felt nauseous. My husband left work early to pick her up. However, once she was home, she had no sign of illness and was very happy and interactive through the dinner hour and into the evening.

A week later we got another call from the nurse that our daughter had a stomach ache and wanted to go home. She told the school staff that I was at home (which was not the case) and that she wanted me to pick her up. I spoke with the Dean of Students who reports that our daughter just seems to want to go home.

We cannot pinpoint any cause for this behavior change. Any ideas of what could be causing these sudden changes in her sleep pattern and her behavior at school?

Answer:

There may be two different issues here. Some researchers now wonder if symptoms of anxiety and depression, in both children and adults, are in some cases caused by a sleep disorder.

Sleep specialists look at bedtime routines. Has your daughter's routine changed? Has your family's dinner time or bedtime schedule changed? Is her bedtime consistent? Is she still using comfort measures, such as a stuffed toy or night light?

It's important to develop consistent bedtime routines and make sure she goes back to her own bed upon waking. Being allowed to "hang out" with you when she gets out of bed would reinforce her behavior.

You may want to ask your pediatrician to evaluate your daughter for any medical causes of sleep disturbance.

If children refuse to go to school or develop physical symptoms (most frequent are stomach and headaches) after being at school, it is often thought to indicate separation anxiety. The most common ages for this are 5-7 and again at 11-14. These are times when adapting to school pressures can be difficult for some children. These separations are not so much about being at school, but about being away from the safety of parents and the home environment. Talking to you child may shine some light on the subject.

Although you can't pinpoint anything, the most common triggers are:

    * Getting accustomed to uninterrupted time with a parent at home after being sick or on vacation.
    * The deaths of family members or pets.
    * Moving or a changes in parents' schedules or routines.

Q&A with Debra: My Child Bites Her Fingers

Question:

I have a fifth-grade daughter who recently turned 10 and who bites the skin off the tip of her fingers when she is nervous. I noticed this behavior earlier this year after a transition to a new school. I spoke with her about it and discovered she was having difficulty adapting to the new school, the teacher and making new friends. I monitored the situation for a while, and I spoke with her teacher about it. I bought her a series of books on self esteem, etc., and it seemed to help her so she stopped. Over the summer she was fine.

I recently noticed her fingers and saw they were red and raw. When I asked her about it, she was embarrassed and did not want to talk about it. Last week I had a parent-teacher conference and her teacher had nothing but good things to say about her and her work.

I spoke to my daughter about it later on and she told me she bites her finger tips during chorus. She said her chorus teacher yells a lot and this gets her nervous. She has chorus twice a week. This is a new teacher at the school. I told my daughter I will call and speak to the teacher about it, but frankly, I don't know where to begin. Could you give me some pointers?

Answer:

Talking to both your daughter and her teachers was a very good start. You want to gather as much information as possible to understand how your daughter copes with her anxiety. From your account, after she adjusted to her new school, she stopped biting her fingers. Then she began again when she was confronted with a new stressor; the yelling chorus teacher. It looks like a pattern is forming. When your daughter is anxious she relieves her stress by biting her finger tips. As you are aware, this is not an effective coping strategy and if left untreated, could lead to even more serious self-injurious behaviors.

You mentioned that you had her read self-esteem books. I think it is important to look at all the factors that contribute to self-esteem. We are complex beings that respond to life depending on a variety of factors of both nature and nurture. It is possible that your daughter is more susceptible to anxiety, but that does not necessarily mean she doesn't feel good about herself. What could affect her esteem is her embarrassment over her compulsive behavior.

This is nothing to be ashamed of. We all have different coping styles. It would be important to seek out professional treatment to help your daughter better understand her anxiety. A behavioral pediatrician, licensed psychologist or child therapist can help your daughter learn better coping skills. Make sure the professional has training in anxiety/compulsive disorders.

Lastly, I would encourage you not to wait and see if it goes away again. You are correct in being concerned and the sooner your daughter learns to manage her anxiety, the better she will be prepared for life's many challenges.

Q&A with Debra: How can I prepare my child for the first day of kindergarten?

Question:

How do I prepare my daughter for the first day of kindergarten? I know the first day is a big deal for kids. With new faces and friends to make, an unfamiliar teacher, and a longer school day, kids can find "big-kids school" pretty scary before they even reach the classroom door. How can I help my daughter get ready for these unique challenges?

Answer:

It is wonderful that you recognize the exciting challenges your daughter is facing.

Here are some tips to help prepare for the first day of kindergarten:

    * Start by attending school orientation meetings. If there are none, ask if the teacher can talk with you before school starts. The more you know about the schedule, the better able you are to prepare your daughter.
    * Talk with your child enthusiastically about school without overdoing or forcing it.
    * Tour the school before the school year starts to orient her.
    * Use a calendar countdown for one month prior to the start date.
    * On the first day of school, show her where things are in the classroom (her seat and cubby, etc.)
    *  Acknowledge her worries and tell her that the teacher is there to help her if she does not understand or is scared.
    *  If she has been in preschool, let her know how kindergarten will be the same or different.
    * If she has not had school experience, let her practice being away from you an hour at a time at a playdate or with another adult. Work up to a full school day away. Have her try classes that involve participation to help her learn rules.
    * Reading books about the first day of school can help ease any fears she has. Even if she is not overtly anxious, it will spur conversations about school. Try Wemberly Worried, by Kevin Henkes, and the Kissing Hand, by Audrey Penn.
    * Buy school supplies together.
    * Be prepared for the first day of school.
    * Give her a comforting object she can keep with her. Check with the teacher to make sure you know what is permissible to bring. If no toys or stuffed animals are allowed, then try something small like a sticker she can wear or a note from you in her pocket.

Q&A with Debra: How Can I Teach My Stubborn Child?

Question:

My daughter is very bright and intelligent, but she is so stubborn. She knows some of her letters and numbers, and she knows how to spell her first name, but I've been trying to get her to sit down with me and learn other things that she will learn about in school. For instance, her address, phone number, spelling her last name and learning how to write her first name straight and not having the letters spread out all over the paper.

I tell her "You're going to need to practice things like this because your teacher is going to ask you to do these things." The answer I get is "I'll do it for my teacher; I just don't want to do it for you." Am I being unreasonable here? Do I need to just respect that answer? Am I expecting too much from her? I was a kindergarten teacher for about five years, and while I was teaching half of the class would know their letters and half wouldn't. My thinking was if the parents could spend more time teaching their children, then they might do better. I guess I don't want her teacher thinking that I'm a slacker parent. I'm very involved in what she does and what she learns. I want her to excel in school and not be perfect but I do want her to try and not be so stubborn.

Answer:

As a former kindergarten teacher, you realize that there is a wide range of readiness that can influence how a child begins to view school. By preparing her, you hope to make her first school year easier and positive. That is not unreasonable. However, I believe if we examine the questions you put forth and your daughter's subsequent reactions, we might find that there is an over emphasis on what "people might think." You state, "...I guess I don't want her teacher thinking that I'm a slacker parent." This concern puts undue pressure on you as a parent and a teacher. Telling your daughter, "You're going to need to practice things… because your teacher is going to…," may be too future-directed. It doesn't allow your daughter to form her own relationship with the teacher as it occurs.

Her response, "I'll do it for my teacher, I just won't do it for you," may not be about her being stubborn. It could be a clue that she is expressing the anxiety that both of you are feeling about her starting kindergarten.

You have the advantage of knowing how to make learning fun and interesting. Relax into that knowledge. Activities such as playing school together and asking her to be the teacher, may also give you ideas on how she may be feeling. Create a list together of her strengths and what she already knows. Model your enthusiasm for learning, rather than performance and outcome and she will be more likely to learn the skills she needs and lessen her power struggle with you.

Q&A with Debra: My Granddaughter Doesn't Test Well

Question:

I have a granddaughter in the fourth grade. Her parents help her every day with her homework. She can tell the correct answers and does quite well. At school when given a test on the same subjects, she will receive a C, a D or an F. We have talked to the teacher, but all she says is that they will keep her back in the fourth grade next year. We do not know what to do. We have had her tested and all is OK. So where do we go from here? Can you give advice?

Answer:

I would like to address the issue of retention first. Retention, especially in the higher grades, is usually considered only after a variety of factors have been explored and weighed as either supportive or detrimental to a student's individual needs. Schools consider standardized test scores, behavioral and emotional issues, the results of psycho-educational tests, and overall school performance history; not just how well children do on their individual subject tests.

Your granddaughter's parents may want to have a meeting with the teacher, principal and special education team to determine your granddaughter's needs. The Department of Education in California calls this meeting a Student Success Team (SST) meeting, but many states have a similar procedure of early intervention to determine how best to help students. This would be very important to weigh all the options before retention occurs.

Poor classroom testing is usually considered "test anxiety," which is a form of performance anxiety and needs to be addressed as a separate issue. Test anxiety usually gets reinforced when the child has had a bad test experience and fears that this will happen again. The anxiety caused by repetitive fearful thoughts, and/ or by the physical reactions such as pounding heart, rapid breathing, sweating, shaking and nausea, can be very intense and makes concentration very difficult. A school counselor or child therapist can give your granddaughter tools to help lower and control her anxiety. Tools such as visualization, deep breathing and positive self-talk are useful for a variety of situations, not just testing, and can become a part of good self-care.

Family anxiety naturally increases when you see a loved one struggle. Sometimes in our effort to be helpful, we can inadvertently add more pressure, so collaboration with the counselor can be a wonderful way to manage everyone's stress.