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Caring for the High Maintenance Child
By Kate Andersen.

The Child Outside the Home. Toilet training.
July, 2010.
Dear Kate:
I took a copy of "The Difficult Child" to our child's psychologist who said that the temperament traits listed in the front of the book were 'overinclusive'.....
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THE CHILD OUTSIDE THE HOME. TOILET TRAINING.

BEHAVIOR - The Child Outside The Home. (cont.) --

Many young children who display difficult behavior at home, also do so outside the family - at day care, with relatives and out in the community. Their parents often find this extremely embarrassing and frustrating. Experience suggests that difficult behavior outside the home greatly increases some parents' dissatisfaction with their children. In some cases, the parents' feelings may then be taken out on the child once at home, in subtle or in obvious ways. As well, the adults in other settings may also be intolerant of the children and may send rejecting or critical messages which may have a direct impact on both the children, the families and the children's peers.

Clearly, children who are disliked in this way are at serious risk of having self-esteem and other problems. Parents are often puzzled by the fact that their children behave differently for different people and in different places. Even some professional people question a temperamental basis for behavior that does not occur across situations. This oversimplified notion of temperament falls down very quickly when you consider shyness, for example. Shyness, agreed by nearly all developmentalists as often having a strong basis in temperament, by definition does not occur with familiar people. Other aspects of temperament will also be shaped by the particular context.

A normally inattentive child may be quite captivated by novelty in a given situation, whether it is the pediatrician's stethoscope or a new video-game. Experience suggests that the following patterns are common in cases of temperament-related behavior:

1. THE CHILD WHO IS SEEN AS 'HIGH MAINTENANCE' ONLY BY THE FAMILY.

Children with classically 'difficult' temperaments may not pose any problems in group care or when visiting another family but reserve the stress-based reactions for home. Sometimes it is the family dynamics and poorness-of-fit with parents that explains this discrepancy. In other cases, however, careful observation will reveal a child who is tense and withdrawn in a group setting but has sufficient self-control to inhibit an overt reaction until later. Such children have been seen to 'explode' with a tantrum the minute the parent arrives or the minute they get into the car. Older children may fall apart in the evening at home. In these cases, while the parent-child fit may be relevant and needs exploration, an investigation of the child's actual functioning in group care or while visiting can be fruitful.

CAREFUL DETECTIVE WORK IS NEEDED.

While it is difficult sometimes to detect the distress in a child who does not display it obviously, good observation may reveal that the child is struggling with some of the expectations of the other setting. These struggles may be related to temperament, as in the demand for smooth transitions from one activity to another or the requirement to eat a food that is unfamiliar. Interpersonal problems of fit can be relevant. Commonly, this is noted when a teacher or relative displays impatience with a child's temperament-related behavior, in subtle or obvious ways.

HOW CHILDREN ARE CHALLENGED.

One of the most difficult areas to address is the use of common teaching methods or directions which are wrong because they do not really address the temperament issue for the child. An example is taking the time to reach a child the methods of "taking turns" with a toy and not recognizing that it is not a lack of SKILL in turn-taking causing the struggle for the child, but a temperament issue such as wanting to play longer with a toy because of temperamental persistence. (In this case, the missing 'skill' is frustration tolerance but it is not always possible to remove frustration related to temperament 'violations', especially in young or 'extreme' children.) Or a relative may tell a child not to 'be so picky' or say "What's wrong with my cooking?" when the child is displaying temperament-based reluctance to trying a new food. Many children lack the awareness, the vocabulary, the assertiveness or the emotional security, to say: "I have some strong food preferences. Do you mind if I don't try this time?" They may just wear an expression that offends the relative. Or they may engage in a behavior to distract everyone from the real issue. Or they may suffer in silence and feel very misunderstood and misjudged.

 
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