Bedtime Routines

I believe our souls call out for consistency in the form of predictable, daily routines. I am sure that life would be boring for most of us if everything was predictable and routine, but when learning something new and potentially challenging (like how to eat or sleep or drive a car), a consistent order and flow gives a comfort that enables new things to come more readily to us.

Bedtime is a ritual that rewards parent and child alike.

For the child, having a bedtime routine signals what to expect as they transition away from the wakeful part of their day where they acquire new skills and encounter new situations at a ferocious pace.  The order in which the routine unfolds matters a great deal, but can vary depending on what you know about your child. For example, certain children become animated during bath time (or don't even like getting their hair wet), while others begin to quiet down and doze. If your child becomes more animated or upset during the bath time routine, starting bath time sooner or only bathing every other night might be an easy place to modify things.

For the parent, having a bedtime routine gives you a chance to gently guide your child toward a restful state that readies them for falling asleep. It also provides an opportunity to lay the foundation for the next day (picking out clothes after looking at the weather on your phone). 

For the parent and child, the bedtime routine provides an opportunity for bonding and more attentively observing the subtle ways in which your child responds to their world and others.

Recommendations to consider with the bedtime routine:

Provide your child with a clear indication of when the bedtime routine will begin. For example, you could say, “In ten more minutes” or “at 7:30, we will get ready for bed." For some children, setting an alarm (fun song) on your smartphone could be a creative support.

Pay attention to how you announce the bedtime routine. For some children, saying, “Time for bed” is the equivalent of saying, “the fun thing you are doing right now (e.g., playing with toys) will have to end soon because I said so.” Instead, try changing the way you state this by using a preferred activity or item as part of the announcement. For example, you could say, “Time for bubble bath!” or “silly story time is soon!” This reminds children of the fun parts of bedtime.

Start the bath early enough that you don’t have to rush your child through it. If your child likes to play in the tub, build in extra time by starting earlier so that they can have more time to play in the bathtub.

A lot of kids have a hard time transitioning from the bathtub to getting dressed and brushing their teeth. In these situations, I'd recommended leading with a clear contingency that gives them something to work for and look forward to. Something like, "Once you hop out of the tub and have your pajamas on, you can pick an extra book!" Help them get dressed and praise them for using nice hands. With tooth brushing, I think having your child pick out a favorite toothbrush from the store and/or a preferred tooth paste container can help make this part of the routine fun.

I really like background sounds or some for of white noise when I sleep, and both of my little ones have a white noise machine in their room. It's also served as a discriminative stimulus for my kids -- sleep machine turned on signals little butts into bed in order to have story time.

Since starting my private practice, I have had the opportunity to work with more than one family to improve their bedtime and sleep routines. I really enjoy this type of work, besides who doesn't enjoy a good night's sleep?

Have on Hand: Extra Socks

Summer fun with kids often includes festivals with bounce houses, playgrounds, bounce pillows, and other play places.  On the one hand, summer often means flip-flops, sandals, and crocs – in other words, footwear without socks.  On the other, “No Shoes” is a pretty common rule when enjoying these different jumping experiences. But socks are usually required.

So my life hack here is a footwear accessory that we forget but often need during the summer.

Socks

On one recent trip, my Better Half sat barefoot while our daughter donned ridiculously large adult athletic socks up to her knees so she could jump to her heart’s delight. We’ve also been squeezed into purchasing overpriced socks just so our kids could participate in an activity. Not to mention that time we got stuck in a downpour and the kids complained about wet socks and shoes the whole ride home.

We’ve since wised up and now keep an extra pair of socks for everyone in the car. My Better Half took it a step further and put an extra pair for both kids in her purse when she knew there was a birthday party soon at one of those bounce places. Luckily, our kids were in sneakers that day and arrived at the party in sock-covered feet. There was a friend who didn’t remember that detail, and we were able to "come to the rescue" with clean socks for them to borrow. So grab a clean pair of socks for everyone and throw them in the car. Maybe even store them in your plastic bag...

Have on Hand: Plastic Bags

Summer is in full swing.  And in the the whole of Rochester there was a joyous exultation, except for those who now complain that it is too hot!

Now that the warm weather is here to seemingly stay, my family is getting out of the house more for a broader range of activities. Over the last few weeks, we eagerly approached several activities only to realize that we were missing an essential item required for participation or a helpful item for cleaning up after said activity. From these mishaps, I will be posting "life hacks" throughout the summer about basic items we've needed on hand at all times to pull off a successful summer excursion. Without further instruction, I present to you...

Plastic Bags

If you're like me, you probably have bags of crumpled bags lying around your house. After unpacking from a big shopping trip, we amass a pile of them with no immediate use.

I can tell you that one of those piles now live in the trunk of our car. The most immediate summer use was to contain soaked bathing suits after a trip to the pool.  Everything was packed, neatly and dry, for our day at the pool.  However, the end of a trip to the pool cannot be characterized as either neat or dry, and usually involves hungry, exhausted children. It would have been really handy to throw those wet suits and towels in a plastic bag to carry and transport home. It’s hard to believe that something as ubiquitous as a plastic bag is so truly impossible to find when you really need one. And I shudder to share here all of the sanitation-related situations we've encountered where something horrific has been contained within a plastic bag lulling around somewhere in the car. Praise be for those plastic bags!

My very own ADOS kit has arrived!

When does an adult get the chance to spend a ton of money on kid’s toys?  I’ll tell you when…

When they open a private practice and are prepared for ADOS testing on their first day on July 11!

Let me start by first explaining what the ADOS actually is. The formal description is as follows:

The Autism Diagnostic Observation Schedule (ADOS) is a semi-structured assessment of communication, social interaction, and play (or imaginative use of materials) for individuals suspected of having autism or other pervasive developmental disorders.

In a nutshell, the ADOS is a series of structured play and conversation opportunities that aid in determining whether someone meets criteria for autism spectrum disorder. Now the diagnostic process has many more components to it (e.g., a caregiver interview, review of educational records), but getting down on the floor with kids and interacting with them face to face is one of my favorite aspects of my job. To accurately and comprehensively diagnosis Autism, researchers standardized the “play” components so that each person receives relatively similar social opportunities. This test arrives in the form of paperwork protocols and a giant box-o-toys. My new office mates at the practice on East Avenue were shocked when a huge, heavy cardboard box arrived in the waiting room one morning. The box was big enough to hold a love seat, specifically this one. I had a great time unpacking and organizing the contents. For those of you who know how much I love organizing and sorting things, this was its own reward...

These are the materials for the ADOS for older children, adolescents, and adults.

These are the materials for the ADOS for toddlers and young children.

I have been administering the ADOS for many years and received great clinical training on how to interpret the results of this assessment as part of my graduate and post-doctoral training. Today marks an important day for me because now I get my very own set of toys that I get to share with my patients and their families at both of my office locations.

One added bonus is the shipping box:

It was so huge I brought it home to make a play house – talk about a great investment. 

A new home for favorite toys. Note the Dinotrux "bad guys" figures stored in the back of a garbage truck.

"Why is my kid is crying?"

In a hurry on a Monday morning, we herded our adorable children like wild cats into the back of our car.  And for reasons that remained beyond us both, our son began to wail.

What in the world is he crying about? 

If I had a dollar for every time I thought this about my kids, I’d be a wealthy man.

Crying is a form of communication that evokes so many emotions, both in the self and in others. Crying is a complex and controversial behavior with its own separate domain of critical research. But somehow, many caregivers learn to decode their children’s crying and react emphatically.

How we respond to crying is really important, especially when someone is not able to communicate verbally. This could apply to a child who does not have words yet or a verbally fluent adult who has a hard time “finding their words” when they are emotionally activated.

There’s no one “right way” to respond to crying, but here are a few tips that I’ve found helpful:

1. Listen (rather than trying to problem solve)
2. Observe (rather than act on the other person)
3. Assure (rather than trying to correct or calm) - “I’m here” or “We’ll hug at school”

So you might be asking yourself: What exactly did you do when your son was crying that day?

I’ll tell you:

1. We put him in his car seat (because we were late, of course)
2. I drove as calmly as I could to school (which thankfully was only less than a mile away)
3. We listened through the trill for his words to come to him (which they eventually did)

Why was he crying?

Because we turned off his “movie show” before it was finished. Curse you Daniel Tiger and your end of show skit. Next time, we’ll try to give our little man a warning that we need to turn off the show.

Ugga Mugga my friends. Happy Monday morning.