Advice Needed

[Guest]

Hi everyone

Interested in your advice and opinions. Have a 3 yr old girl in my setting who has been with us for nearly a year. Had major problems settling, refuses to be comforted, cries a lot, wanting mummy, but will eventually settle and play in limited areas but requires lots of adult support and reassurance. She has "latched" onto a member of staff who is leaving soon and a couple of other members of staff, but if someone new comes into the setting she freaks out, starts crying again and you are back to square one, trying to get her to calm down and do an activity.

She spends time watching the other children but is reluctant to join in, and uses her anxiety as a way to control, if that makes sense.

She gets attention by crying or shouting, so we are trying to ignore it and be matter of fact and not enter into the whole "mummy back soon" conversation with her. This is having a little success and she will start some activities on her own when she realises ahe is not getting a reaction. This feels very harsh, but otherwise we are affirming her behaviour that if she cries and shouts she gets attention.

 

We are going to try doing small games with her, introducing other children into them (turn taking etc) in the hope that this might help, but it concerns me that a child so young can have such problems with anxiety and low self-esteem. Mum reports that she is like this in any new situation - freaked out going to the dentist!

 

Any ideas or articles you can point me to would be great. She starts school next year and really want her to be able to cope. It is also exhausting dealing with this when she is in and takes you away from other keyworker children who need you. The other children are also starting to get annoyed at her crying and interrupting during stories and at snack times!

 

Thanks

[Guest]

Separation Anxiety; Could google or ask an EP.

Not saying this is what it is, bit no harm in investigating.

 

\if she is using it as attention seeking, whay? What is it that she needs attention for?

[Guest]

If you find no obvious cause using the usual observations etc I can personally recommend a book by Sam Cartwright-Hatton called something like How to deal with an anxious or depressed child. I was on a clinical trial with her for the development of her work and it really worked with my daughter. It is aimed more at parents but as a practitioner I took things away from it for work too. If there is no obvious cause ( and with my daughter there wasn't) it might also be helpful to share it with the parents as a consistent approach would work quicker. On the trial there were parents who had young children who sounds similar to this.

[Guest]

Do you have a visual timetable for her? i.e a sequence of photos showing the pattern of the morning / day. She could then see when Mummy will come back, which can sometimes help.

For a child like this we also sometimes plan in a short 1:1 time with the keyperson and the child, when the child can choose an activity they would like and which is NOT a reward for 'good' behaviour (and is never withdrawn for unacceptable behaviour) but is an opportunity to build their relationship in a planned way. I know 1:1 sounds like a luxury, but she is taking a great deal of time anyway.

I also wonder if there is something else she can do so she does not have to stay in story / snack?

If she has been like this for a year, you may feel it might be worth starting to get some advice - can your Senco talk to your Area Senco informally, for example, to see what help is available locally for transition to school?

Gruffalo2

[Guest]

Thanks. Not sure if this is just seperation anxiety, we have a visual timetable but not really helped. She understands that mummy is coming back but finds it hard to let go and join in. Not had a child quite so extreme as this. Have advised mum to chat to HV as she is getting upset about it all now and will chat with Area Senco on Thursday. Will persevere and see if we can encourage some friendships within the group and maybe stay and play sessions at children's centre (?) to help.

 

Let me know if you have any more ideas!!

[Guest]

Yes, another idea!

We have also tried asking a Mother to let someone else bring a child (family friend or relation). It just breaks down the process of leaving into smaller steps.

 

However, from what you describe she does sound extreme, and if Mum is getting upset too, it's time (in my opinion) to call in all advice you can.

 

Gruffalo2

[Guest]

Hi there -

 

This reminds me of two children we had in nursery - both displaying exactly the signs you describe but very differently. The first we eventually took the cruel to be kind option as you said as we all agreed she was using the behaviour as a control mechanism both at nursery and at home. Once she began to realise that we and the children were not responding to her she quickly began to join in, cooperate, smile and turned into the happiest and most bubbly little girl. We still had the odd moment but she soon realised that when she used her emotions appropriately she recieved an appropriate reaction from us all. She is still winding Mum round her little finger but you can't win them all. The second again showed all the same signs but it quickly became clear that there were underlying issues which were causing her deep anxiety . She needed constant reassurance, was fixated on routines (- some of her own making)and certain adults but had excellent verbal skills. We are convinced she is on the autistic spectrum and are awaiting assessment. Having worked with many SEN children over the years I can vouch for the effectiveness of visual timetables and clues and also giving children extra warning time before each part of the day/ loud noises/changes to routine/busy times/moving elsewhere in school - ie PE , etc. I don't knowc that this is much help but it may ring some bells - good luck - hope you get her - and you(!) to a happier place soon

[AnonyMouse_1195]

I think that using the strategies used with ASD children would be applicable with this child even if she is not on the spectrum. There would be other issues you would have identified by now if she were, as Pollyputhekettleon mentions. Clear routines, visual timetables or clues, and a short time of 1:1, confident adults who make playing fun, consistancy in approach and, as you are doing, trying to involve her in play with one or two others will help. She has nothing to fear so reassurance is not necessary, and can be counterproductive. Perhaps it is time to put an action plan in place setting some small steps for her to achieve, and working with her parents on these. Then she is on the first rung of the SEN procedure which can be continued if she needs assessing later on if your strategies are not working.

 

Funnily enough I was at an ASD Conference yesterday and one of the quotes was " “Autism is anxiety looking for a target.” Autism and anxiety go hand-in-hand. "

 

A child like yours can be exhausting so keep going and good luck.

[AnonyMouse_15046]

If you feel that she is using this behaviour to gain attention perhaps she is worried that this is the only way she will recieve the attention that she really needs. It may be that the one to one time suggested earlier would give her attention which she does not have to 'win' by behaving in the way you describe.

 

Once she realises that she gets attention without trying for it she may feel more secure. If staff feel that she is taking up more than her share of their time they may be communicating this to her without realising it by moving on the moment she appears settled. She needs to know that she is valued and spending extra time with her unconditionally may be the way to show her this.

 

If nothing else it will help you to have a clearer picture in your discussions with the Senco.

[AnonyMouse_64]

I had a child like this at playgroup a few years back. The anxiety and distress she felt was very real! Instead of looking at it as the child trying to 'control the adults', think of it more as her trying to find strategies to control the very real feelings she is having at these times. As a child this is obviously what she has found works for her in the short term, but it won't help in the long term. As adults we need to help to put into place strategies that will actually improve their quality of life for good.

 

I myself also have an anxious child and have spent some time researching to find the best way to deal with her. As someone else has said, constant reassurance is actually counter productive, even though this may be instinctively what you may do if a child is distressed. What you are actually communicating to the child is that they are right to feel anxious, as you are focussing on their fears. Instead you need to find out what it is they are worried about - depending on their age you could use puppets or toys to act out various situations to work out what is distressing them. Never jump to conclusions yourself about what is worrying them as you may be wrong - we can never know what someone else is thinking. When you know what is worrying them you can use stories and puppets to 'act out' the situation with different outcomes. This helps the child to see that what they are worried about, whilst a possible scenario, is not the only one and hence is unlikely to happen. It will also illustrate to them how they could react in any given circumstance to change the outcome, thus making their fear less likely to happen. It might also help to use a circle time activity to discuss it with other children. Who else is frightened of the same thing? How do they deal with it? Has it ever actually happened to anyone? This helps the child to see that we all have worries but don't let it rule our lives. Additionally it helps to put it into perspective - whatever it is they are worried might happen has never actually happened to anyone else!

 

A book I can recommend is What to Do When You Worry Too Much: A Kid's Guide to Overcoming Anxiety by Dawn Huebner. This is aimed at the child and helps them to be proactive at dealing with their worries. My daughter found it very useful.

[AnonyMouse_15046]

Sorry to go off topic a litle bit but do you think this book would help my 12 year old daughter who is becoming so anxious about school that I am concerned it may be developing into a phobia, Beau?

[Guest]

Upsy Daisy, I don't know about the second recommendation but the book I mentioned could certainly help. Some of the children involved in the trial sounded very like yours.

[AnonyMouse_15046]

Thanks Holly35. I'll have a look for it.

[AnonyMouse_64]

Sorry to go off topic a litle bit but do you think this book would help my 12 year old daughter who is becoming so anxious about school that I am concerned it may be developing into a phobia, Beau?

 

To be honest its aimed more at younger children - your daughter would probably find much of it too patronising.

 

The best thing to do with your daughter is talk through her fears and encourage her to get them into perspective. What exactly is she worried about? Don't give her answers to her worries i.e. 'That would never happen because........... so I don't know why you are worrying about it' She obviously thinks it will happen - telling her not to worry isn't going to take the worry away. She also needs to draw her own conclusions but you can guide her thought processes. Why do you think that will happen? Do you know anyone it has happened to? How likely do you think it is? etc. If some of her fears are about how she appears to others then turn it around and ask her what she would think of someone else in that scenario - would she think they were stupid/laugh at them/poke fun etc.

 

Being a parent can be a minefield at times, can't it! I hope you manage to sort it out.

[AnonyMouse_15046]

Thankyou for that Beau.

 

I will be really careful not to dimiss her fears.

 

I'll try to get hold of the book recommended by Holly35 and keep trying to support her.

 

It certainly doesn't get any easier as they get older that's for sure.

[Guest]

It certainly doesn't get any easier as they get older that's for sure.

I'll second that! When can they move out?

Edited September 16, 2009 by Guest