Between a rock and a loud place

Imagine sitting in a classroom and hearing all the noises in the room as if they were in an amplifier next to your head. And then imagine trying to follow the teacher's directions through all that noise. Imagine trying to figure out what the teacher said when you miss 30% of the words or the words themselves become garbled in your mind. Imagine you cannot quickly recall what someone just told you.

Sounds miserable, right?

In fact, after 10 minutes of experiencing these things in a simulation, I had a splitting headache and felt homicidal. It was exhausting. 

It's my son's life.

A year ago, testing showed my son had an auditory processing deficit - and that his ability to process auditory information was dramatically lower than all his other intellectual abilities. It wasn't until a chance conversation with an Otolaryngologist that we realized we could understand the details of this deficit and potentially help.  We had him screened by a pediatric audiologist who diagnosed him with Central Auditory Processing Disorder - CAPD - a disorder that impacts 2-5% of the population with twice the incidence happening in boys. It's often undiagnosed because the children can hear well. In fact, many children with CAPD act out in school because they are so frustrated by what they hear or they just need the sound to stop - leading to being designated a "bad" or "wild" child, "willful" or "ADHD".  ADHD can exist with CAPD - but they aren't the same thing.

We are very lucky.  Our son's CAPD did not coincide with reading dyslexia or speech issues. In fact, so far, it's only really impacted his behavior. As soon as we received the diagnosis, it was recommended that he complete Auditory Integration Training.  This therapy was developed by Guy Berard, MD and consists of frequency optimized 30-minute intervals of music where they modulate the treble and bass as well. The sounds train the brain stem - and help address imbalances in processing sound.  My son's AIT focused on reducing the volume of sound at 4000 Hz - the frequency of crowds. He diligently listened for 30 minutes every morning before school or sports and 30 minutes every evening. 

The results from the mid-program audiogram were amazing - and when we drove to Montana after he completed the program, he sang on key for the first time in his life.

It will take anywhere from 1-6 months for the full impact of AIT to be seen. In the meanwhile, he has to learn to restate what he hears, advocate appropriately for himself when the sound is too loud and we have to work with his teachers to have compassion, provide him information in visual modalities, and help him unlearn the behavior patterns he developed out of frustration.  The coping mechanisms that he uses to excel academically must be reinforced as the work becomes more challenging - CAPD is a lifelong disability, but it doesn't need to hold him back.

To learn more about identifying and treating CAPD - here are some resources.


The Security of Strong Identity

During the winter holidays, my children are constantly reminded that they are minorities by faith. When they were very small, they'd protest that there were pictures of Christmas Trees and banners proclaiming Merry Christmas, but no menorahs or Happy Hanukkah signs. It was very interesting that after a year in Jewish Day School, their protests simply stopped.  They still noticed, but it didn't bother them as much.

Last weekend, my eldest was asked by his cousins (who are part of an interfaith family) if he celebrated Christmas. He simply replied - no, I celebrate Hanukkah. They mentioned that they celebrated both Hanukkah and Christmas. And then they asked him if he wanted to celebrate Christmas.

I wasn't in the car. My sister was driving and listening. Previously, she's shared that when she was a child, she was very aware that everyone else celebrated Christmas and it looked like fun. That she didn’t like that she felt different. She shared Benjamin's response with me - because he delivered it so surely, it was memorable.

Not really because I'm Jewish and I don't want to celebrate Christmas. I'm happy with Hanukkah.

There was no judgment or advocacy in his tone or his intent. He's simply secure with his identity - he's Jewish. He celebrates Jewish (and American) holidays. And he's perfectly comfortable with his cousins making a different choice that fits them. 

His surety of identity is a direct result of his pluralist, Jewish day school education. Pluralism means that he has been taught that there is no one right way to practice Judaism or worship G-d.  Jewish Day School education means that his formative years are imbued with celebration of his holidays (and study of others).  Research indicates that the more diverse the environment, the more children self-segregate.

It's counter-intuitive. In order to raise a child who embraces diversity, the child has to be secure in its own identity first. My son is eleven.  He is still learning who he is - but he is secure in his faith and his unique individuality. I hope it lasts as he moves through adolescence and into adulthood.  Evidence is on my side that it will.  For now, I'm just proud that he can share his pride and comfort in his tradition without making his cousins uncomfortable. 

Ideas for impulsive boys

Parenting can be very lonely - especially when your child is frustrating or embarassing you.  I started writing to share my experiences and join a community of practical, grounded parents who know there are no perfect children or perfect parents, but want to enjoy parenting.  A mother of a 6 year old boy recently contacted me for ideas to help her with her impulsive child.

My 6 year old son struggles with behaviors as you described of your son.  He's impulsive and is very short fused.  I was curious to know some of the strategies you have tried with your son.  My son has especially gotten bad over the summer.  (I am a teacher and so he stays home with me).  I just feel so bad for him b/c he can be so good but I know SOMETHING is bothering him and making him act like this.  Please help!

 I'm not a mental health professional or a teacher - so I'll share what's worked for us as just that - personal experience and no more. 

  1. Take a look at sleep.  My son is much more impulsive when he's slightly tired - like 30 minutes off.  We forgo homework, which I hope your six year old doesn't have, time with us and pretty much everything else in exchange for going to bed at the same time every night.
  2. Try a simple reward chart - it has to be broken into very short intervals and he has to know what success looks like - so be specific. He should be able to earn points every 15 minutes and when he has a lot of points, there's some reward (a favorite meal, time one on one with a parent, in my son's case - time in a batting cage).  Examples are (in 15 minutes intervals): waits turn to play/speak, responds the first time asked, shares a toy.
  3. Give him an alternative way to express his physical energy - and it will be a physical alternative.  We gave my son a soccer trainer where he could kick the ball very hard and it wouldn't go anywhere.  We taught him some yoga positions that he could create pressure on his body that would calm him.  We got him permission to go run/pushups/burpees/squats.  Something that could not hurt someone else and would help him burn the energy.
  4. He's reacting because he is hurt. Something or someone frustrated or hurt his feelings. Don't invalidate what he's feeling (even if it seems trivial or out of proportion).  Validate it - son, I think you are upset/hurt/frustrated. Son - tell me what upset/hurt/frustrated you.  I'm sorry you feel that way, it must be very hard. We may not be able to change what happened, but we can choose what happens next.  What would you like that to be?  Make sure every adult who supervises him follows this sort of script - he'll calm down much faster if you don't fight him.  This doesn't mean approval - just validate his feelings before holding him accountable for his choices.
  5. Try to teach him a mantra or other mechanism to cool off when he feels upset.  This is really hard for adults - but if you can make it a habit - count to twenty in three languages, add two really big numbers together, something that redirects his mind - you'll help him for life.

He's a work in progress and virtually every interesting, driven man I know was an impulsive and hot headed youth.


When he is closer to 8, if its still an issue, I recommend investing in comprehensive academic, cognitive and behavioral testing with a psychologist qualified and experienced to do all three. We discovered that our son is exceptionally bright/gifted - but that his brain processes information incredibly fast yet auditory processing was well below average.  "People talk too slow" - and he hears so well that all the other noises get in the way while he is waiting for people to talk faster. Once we and his teachers understood his gifts and his issue, we could insist on providing directions to him in writing and giving him an escape from assemblies when the sound is too much.

One thing I noticed you mentioned is that your son found some sort of release.  That is something I am having trouble finding with my son .... other than video games ... *sigh*.  Also, We had my son evaluated by a preschool team and they did say that he is very bright/gifted but also has trouble processing information.

Do you also think that summer vacation is especially hard on kiddos like our boys b/c it is less structured?  What  can I do to help that?  Should I have a set schedule every day (soooo not my personality haha)

We have very strict rules on video games - during the summer, they can use them for 2 hours on the weekend (while we sleep) and one hour, twice a week.  They have unlimited use of Kahn Academy and Typing Ace.  But they are older than your boy - frankly, I'd take away the power cords to the video machines for a few weeks so that he learns another soothing solution.

We make our kids read a book, go outside, draw a picture.  I believe (and there is research to support it) that video games are soothing/brain numbing.  Does your son like sports?  building things? music?

Finally, I live by routines.  The kids know what to expect and when to expect it.  In between those structures, they are free.  It's much less anxious for the kids and we find behavior is much better.  For example, they know they are leaving the house by 8am.  So when they get up, they have to get dressed, eat, organize their stuff before 8am.  They can do whatever else they want as long as those three things are done.  Then they go to camp during the day - or have some sort of input into their day (we're going hiking and then swimming...you can play outside for a few hours, then we are going shopping).  So - I would suggest creating a predictable routine with plenty of time for self-expression, imagination and unstructured play.  But let them know when it will end so that they can plan their play. Teaching executive function while you are at it.

It's not easy - but parenting never is.  Impulsive kids are interesting, creative, energetic and once they learn to harness their capabilities - they truly shine.

Growing up and controlling our impulses

I wonder how many people have tried to learn something or improve themselves and had immediate success?  It takes years to earn a degree and at least 21 days to form a simple habit. One of the lessons my husband is applying as a coach is that a coach (or teacher or parent) needs to give five positive comments for every one negative one. 5:1. The great basketall coach Phil Jackson coached the Chicago Bulls with Michael Jordon using the 5:1 philosophy. How many of us actually parent like that? 

So it's not surprising that as a child is learning something - like the appropriate way to deal with competition, frustration or normal banter/taunting - it would take time to master.  I wrote in December that I was really impressed by my son's rapid adaptation to the accomodations offered to him in the classroom.  We met today with his teacher and learned that those adaptations continue to work and that he, with a few of his classmates, successfully created and introduced tile-math for the first grade (when they had completed their third grade math work) as well as creating (with other classmates) a lesson on the science of crayfish for the kindergarten. Engaged, appropriate and striving. 

But he is not perfect and hasn't mastered everything in regard to his behavior. During unstructuring times like recess and transitions, it's still hard for him to override his reflexes. With the coaching and support of his teachers, he's asked to become conscious of  every choice he makes - physical and verbal - understand the implications, take responsibility, and learn to make another choice. I'm thankful that his school believes in supporting children as they learn and teaches children how to resolve conflict and reflect on their choices. He gets to practice as he's learning. The extensive testing he did showed that his impulses are not a choice - they are a reflex. So while he knows the rules and expectations, he's learning to react in new ways.  It's quite a lot for an eight-year-old boy, but he keeps trying to get it right.  For him, a day when he was successful in class and there are no (or very minor) scuffles at recess or in transitions is a big success. And we celebrate it. He's improving - according to the school.

It's probably challenging for anyone who isn't in the conversations with him, the school and us to know how much effort my husband and I spend with our son working to refocus his impulses and retrain his reflexes.  We're lucky - he's neither mean nor insecure but he is competitive and impulsive. Advantages in sports, but challenging at school. As a friend said - he was born to be on a farm where he'd be working hard, outside, for hours before school. But in spite of our four chickens, we just don't have any hay to bale in the morning.  He's eight and learning to control his impulses.  Something most people I know still strive to do.

5:1 - I'm trying to praise his efforts 5x for every 1x he struggles. He radiates with pride when he succeeds. My impulse is to react when he doesn't and he certainly knows we are disappointed at those times. His struggles are embarrassing and frustrating. They don't happen when I'm present (I'm a calming influence on him). He's not a remote-control robot we can control, nor would we want to. When he is unsuccessful, he knows that he needs to try harder because he is accountable for it at home as well as at school. And every day we have improvement is a success to celebrate.

What a child screaming in frustration sounds like...behavior problem.

My son is amazing.  For the last 8 months (ending 8 weeks ago), he was expressing extreme frustration at school and no one understood what was the cause.  Looking back, he was feeling like in spite of doing what his parents and teachers suggested, he was failing at writing.  And he was really trying. It must have been awful for him.

We subjected him to a barrage of occupational therapy, academic and cognitive testing which he endured with a great attitude. We sent his au pair to school with him as an aide and scribe. His au pair also sensitized him to his own disruptive behaviors.  The OT determined he needed some fine motor adjustments which we started immediately.  In his very first session, he was like a sponge – grabbing on to the modifications his therapist suggested.  A slant board. Well lined paper.

Within two weeks, he started doing his own writing, by choice.  Still not very neat – but not frustrating either.  For months, he had been frustrated because he was trying to fix himself and failing.  No one – his parents or teachers – was helping him or explaining to him why all his efforts (and he was working hard) were failing. It was excruciatingly frustrating – he doesn’t give up and he knew he wasn’t succeeding.  But once he saw the path – he ran for it and never looked back.

Would you believe that from the day the au pair arrived in school, my son completely stopped having behavior issues? 

It took longer to get the results from the academic and cognitive testing – and even longer to synthesize those results into something that fit my son. It’s easy to fall into a diagnosis with the justification that it would give everyone a common language – but that was never our goal.  Our goal was to figure out what was making our son crazy at school but happy at home and with his friends. 

We learned that he’s exceptionally bright and that his brain processes information exceptionally quickly.  Meaning that he’s easily bored and needs a lot of challenge. We learned that in contrast to all that, his auditory processing abilities are below average – meaning that he actually cannot process auditory inputs very well. This means that when you give him spoken instruction, he’s not getting all of it. And he’s working double time to get what he gets.  He needs instruction and information provided in writing.  Not surprisingly, so does his Dad.  His Dad graduated with honors from Harvard and didn’t go to his lectures because he got what he needed from the books. But he knows he likely could have gotten even more if he dealt with his auditory processing challenges. So we’ll help our son with that issue to see if we can help him get more out of spoken instruction. 

To top it off, when he’s frustrated or bored, he’s impulsive and energetic. It’s not a reaction he’s choosing – it’s his wiring.   For years we’ve joked that he doesn’t idle well – we were right.

But the amazing thing is that he took advantage of the information from his au pair and his OT to self-adapt. Once he realized that he can keep himself busy with a book or an art project AND that he enjoys being in class reading, writing and participating – it was a self-fulfilling prophecy. He’s articulating when he needs to go burn some energy or needs something else to do. And his class is doing a lot more project work and he’s loving it.

Looking back, I think we should have done the OT testing in second grade as soon as we knew his handwriting was a problem.

More importantly, it took a psychologist who deeply considered the academic, cognitive and behavior data all together (and had unlimited observation of my son, to be fair) to discern the true root cause of his frustration - and the reason that his frustration was manifesting in disruption.  My suggestion to anyone going through this is to keep pushing until you get an answer that makes sense - do not let yourself be intimidated by professionals (pscyhological or educational) into accepting a description that simply doesn't fit. And when you have something that fits, move swiftly to help your child. Mine felt like suddenly everyone understood and was giving him the tools to succeed.

Naturally, with all this testing, we also got a plan from the school.  It’s a reasonable plan – but my son is way ahead of all of us. We threw him a life ring – and he grabbed on and learned to swim.  Amazing.

Back to School Traditions

Somehow, the first night all my children slept in their beds since June 20 was tonight (August 30) - and it's the night before school starts. They had busy, wonderful summers visiting family back east, attending sleepaway camp and spending time with family out west - no complaints. But no time to really transition into a school mindset.

Time constraints forced me to focus - to identify the most important back to school activities:

  • Clothing that fits and is suitable for something other than rags. 
  • School supplies 
  • Dentist, orthodontist - check and check.
  • Haircuts...not crucial.  Not done. 
  • Buy books for summer reading - did this in June. Whew.

My time jam also put the sleep routine at risk. Luckily, our children have a pavlovian response to their own bedrooms - or to the exhaustion of their summer - bedtime was on track, without resistance and should lead to a solid 11+ hours of rest before school starts tomorrow.

Beyond the practical, I fantasize about having back-to-school traditions. Thus far, the tradition is taking a day off from work and spending it with my school-age children doing something. Mini-golf is popular. So is bike riding. And lunch. And I fantasize that this experience opens meaningful discussions about goals and concerns for the upcoming school year.  Realistically, it reinforces that I am a better Mom when I work and spend evenings with my children because my patience for sibling rivalry and bickering is, well, not great. 

Most of the families I know from other schools have already started - we start tomorrow. The kids are excited and the parents look estatic. Our big family tradition is to take a picture outside our house before school on that first day. It's not time consuming and it's never particularly calm, but I do enjoy seeing them over the years.

What's your back-to-school routine and tradition?  Is it for you or your kids?

 

 

Feeling good doing good

My husband's cousin was hit by a car in an intersection while finishing a jog a week ago. According to the laws of physics, she should not have survived. Luck was with her and she did - with a long recovery from a serious shoulder injury and fractured hip. She and her family live in Boston and she is doing rehabilitation at Spaulding Rehabilitation Hospital. And it so happened that my family had an afternoon in Boston before returning home and we felt we shoudl visit her - it's an important mitzvah - and the right thing to do.

We were nervous. We weren't sure if she would look battered and if her appearance would frighten our children. We didn't know if she would welcome three kids to her recovery room. And we didn't call ahead since the email instructions were that after 4pm, drop ins were welcome. As we rose in the elevator, we reminded the children of their part in visiting the sick and mentioned that Dad would enter the room first to ensure they could enter.

She rolled out into the hall as we disembarked. And our mitzvah became her gift. For the next thirty minutes, we sat outside with her listening to her talk about her good luck and her love for her family and community. She was disappointed that she couldn't take her boss,  Michael Porter, to Haiti with her other boss, Paul Farmer, in September - they would delay until she could come. She spoke of her luck in being treated at Brigham-Women's Hospital. Her luck that the orthopedic surgeon on call was a shoulder specialist. She shared how good it was that her father-in-law, another physician, was there with her husband to support him in making very scary decisions on her behalf. And she marved that she kept her arm; can move her fingers and is on the road to recovery. She told us her neighborhood was protesting at that very moment to get a traffic light placed at the intersection. She was thankful and appreciative. It was amazing.

Our children spent most of the visit playing basketball while we talked with her. But they saw that something really bad can happen to a really good person and that you control how you react to bad things. My husband and I were inspired by visiting his cousin. I couldn't have created a better opportunity to show that doing the right thing - such as visiting the sick - can be inspirational and educational.  

Bullying or bad behavior - what's the difference?

We are sensitized to declaring behavior bullying.  We all feel compelled to protect our children from physical, emotional and electronic bullying. And we all know that protracted bullying can lead to terrible consequences. 

But it's not always bullying. 

Bullying is defined by physiological and educational experts as repeated attacks on the same child by the same child perpetrated by a child who has more power than the victim. Specifically, from Olweus Bullying Prevention Program (a “model” by Blueprints for Violence Prevention):

"A person is bullied when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons, and he or she has difficulty defending himself or herself."

This definition includes three important components:

1. Bullying is aggressive behavior that involves unwanted, negative actions.
2. Bullying involves a pattern of behavior repeated over time.
3. Bullying involves an imbalance of power or strength.

And as parents, many of us don't distinguish between bullying and bad behavior - making it much harder to deal with actual bullying, creating unrealistic expectations for our institutions and mis-labeling innocent kids. 

Kids hurt each other sometimes. They say nasty things. They get into fights and push each other (or worse). They write stupid and mean things in email or social media. And the child who does any one of those things to another must be held accountable for their bad behavior with swift and appropriate consequences.

Bullying is repetitive. It's intentional. It's bad behavior on the repeat cycle.

I don't sanction bad behavior. Every child makes bad decisions sometimes; and should learn the consequences of breaking a rule. I applaud my school's commitment to positive discipline and I partner with them when my child makes a bad judgement call and behaves poorly. My children know their punishment. And we talk about different choices for the next time. The actions of schools and coaches need to be different for bad behavior and bullying.

Bullying indicates deep psychological issues for the bully. That child needs attention, therapy and perhaps a different learning environment. By definition, bullying cannot be diagnosed in a single incident. But once recognized, must be addressed.

Bad behavior is something that a child does that hurts another arbitrarily. Bad behavior is random. Bullying is purposeful.

So when our child reports being hurt, before we cry "bullying" to our schools and our friends, we need to ask if this sort of thing happens TO YOU repeatably by the same person. Get specific examples if the answer is yes; all children exaggerate but sometimes they don't. Specifics help. In all cases, the hurt child deserves an apology in any case and coaching for how to deal with any future altercations (words, actions, adults).

As parents and a community, we should fight the desire to publicly humiliate any child - it doesn't teach anyone anything. Other than a heartfelt apology, we are not entitled to knowing how someone else's child was punished. I know that when my child is the wrong-doer, he is swiftly punished but not humiliated. I give our teachers, coaches and other parents present permission to mete out appropriate punishment right then and there. Let me know and I'll reinforce the punishment at home. I trust that every other child who does something wrong is dealt with the same way.

Let's stop hurting children, schools, camps and other institutions with the scarlet letter of bullying or a bullying problem. Let's be swift and proactive when bullying is actually occurring. Let's teach our children not to exaggerate by modeling it. By recognizing the difference between bullying and bad behavior, we can help all our children learn and be safe.