Anticipatory guidance for cognitive and social-emotional development: Birth to five years (part 8)

Night wakings: (Table 3)

Temper tantrums: (Table 3)  Stay calm. Do not give in to demands (or he will continue to tantrum to get his way). Prevent tantrums through adequate sleep, regular mealtimes, choices (ie, reduces frustration at not getting his own way), one-on-one time (ie, stops the child from feeling ignored) and, if necessary, avoiding excessive sensory stimulation (eg, grocery store). When tantrums occur, helping him label feelings teaches acceptance of negative feelings and fosters parent-child communication. You will always come across Symbicort Dosage at a pharmacy that will offer best deals.

TABLE 3 Anticipatory guidance for social-emotional development: Normal behaviours

Age behaviour Age behaviour
6 months Separation anxiety:•    Calm him when he protests.•    Transitional object (eg, a blanket) helps him feel calm.

•    Tell him where you are going, when you will return (follow through).

•    Leave with confidence, use a consistent caregiver.

•    Hold him close upon return, until he signals readiness to move away.

•    Daycare: If he is very upset, integrate him gradually, with you present, during part of the initial days.

•    Stay with him during hospitalizations.

2 years Negative behaviours:•    To increase positive behaviours: Give immediate positive attention (eg, specific praise “Good sitting quietly in your chair”, smile, hug).•    Praise positive behaviours at least 3-4 times more often than you identify misbehaviour. Children are not spoiled by praise.

•    To decrease minor negative behaviour (eg, whining): Consistently ignore (ie, even negative attention is rewarding), know that it usually worsens at first.

•    As soon as misbehaviour stops, suggest appropriate behaviour, give immediate positive attention to the positive behaviour.

9 months Night wakings:•    Respond as you do at bedtime.•    Try moving bedtime earlier by a half hour or more. 3 years Grabbing toy:•    Help the crying child, ask the grabbing child why he did that.•    Tell the child who grabbed to share, reassure him that he will get it back later.
18 months Temper tantrums :•    Distract him (eg, alternate activity), remove him from that location.•    Try soothing him by holding and helping to label feelings.

•    If unsuccessful, let him cry it out while you ignore the behaviour, staying in the room with him.

•    Once he will allow it, soothe him, help him verbalize feelings, distract.

3 years Negative behaviours:•    For recurring problems, use immediately:•    Logical consequence (eg, drawing on wall ^crayons removed, helps clean).

•    Natural consequence (eg, dawdling before park ^ no time to go).

•    Stay calm.

•    A child’s feelings about himself are as important as obeying your commands.

18 months Aggression :•    Tell him firmly to stop (eg, “No hitting”).•    Label his feeling (eg, “You’re angry”).

•    Redirect (eg, give him another activity to do).

•    Physical punishment is not effective, is harmful, and teaches violence.

•    Your attachment relationship helps him cope with emotions, spend daily time following his lead in play.

3 years Aggression:•    Time-out to calm down (ie, boring safe area, ignore him):•    Briefly explain (eg, “No hitting/wrecking. You need a time-out to calm down’).

•    Lasts 3 min (three-year-old), 4 min (four-year-old), or 5 min (five or more years of age). It is not over until he has been calm for 2 min.

•    After time-out: Praise his calming down, give him something else to do.

•    Praise his first positive behaviour, encourage verbal expression of anger.

2 years Picky eating:•    Do not coax.•    Ignore it.

•    Serve the same variety of nutritious foods that you eat.

•    He is responsible for what and how much he eats.

•    He will grow up able to regulate food intake based on internal cues of hunger and satiety.

•    Trust that when he is older, he will eat what you eat.

4 years Noncompliance:•    Time-out to calm down (ie, if noncompliant >75% of the time):•    Give command (eg, “Please put your boots away”).

•    When he does not respond within 5 s, warn him of time-out (eg, “If you don’t put your boots away, you’ll have to go to time-out”).

•    Wait 5 s to give a chance to comply. Praise him if he does.

•    If doesn’t comply, take him to time-out.

•    When done, praise him for calming down, repeat the original command.

*Numbers in parenthesis indicate references

Category: Anticipatory guidance

Tags: Child development, Child guidance, Evidence-based practice, Preventive psychiatry, Problem solving, Psychological adaptation

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