All examples of clients in this and all blog posts are materially changed to disguise the identity of any individual.
Karen's a typically developing 6 year old girl. Typical for kids who have both anxiety and ADHD and a possibility of autism.
Her older brother has autism, without any question, and questions have come up about her being on "the spectrum" as well. I'm not too sure that she is, but other professionals have questioned it. I think that her anxiety has blurred the picture and made her presentation look quirky enough that the possibility was raised. But that's not the point of this story.
Karen is a kid who can be quite stubborn, even oppositional, not to mention significantly distracted when asked, or told after a while, to do things. As her mom relates, asking 4, 5, 6 and more times to go to bed, get in the bath, come to dinner, clean up her toys etc. can get old, and even mom, a well thought of teacher admits to losing her cool after a while and yelling at Karen.
I began seeing Karen right before her mom had brought her for a more formal evaluation for the anxiety and ADHD, which I fully supported. typical medication trials began with the typical changes of meds due to ineffectiveness or side effects. Mom and Karen are taking this in stride. Karen has some mild Cerebral Palsy as well, as evidenced by a hardly noticeable weakness in one of her limbs, so she's used to seeing professionals. But mom's main concern is the oppositionality, her refusal to comply with demands at home.
So of course, I recommended Ross Greene's book The Explosive Child (see elsewhere in these blogs for discussions of his Collaborative Proactive Solutions model of problem solving with kids.) Mom was quite open. Dad, not so much, for a variety of reasons. But as Greene says, that's not a deal breaker. One parent can successfully implement CPS without the participation of the other.
We began solving problems collaboratively and Karen was very interested in her ability to have input into the solutions. After the first problem was reviewed and she came back to my office I couldn't even finish the sentence asking how things went with the solution they came up with. She interrupted me with "That problem's solved." I looked at mom who smiled as she shook her head in agreement. So off we went to the next problem, and the next. Like dominoes falling we addressed getting dressed in the morning, going to sleep at night, teeth brushing and coming to dinner when called.
Mom comes in now intermittently for coaching on CPS and related the following anecdote which made me think of Greene's "kids do well if they can." Meaning, if they have the tools to behave properly, they're generally motivated to use them. And if the tools come from their own collaboration, they're more likely to use them. Mom related that she and Karen worked on a certain compliance issue that had come up and Karen, as sometimes happens with her, struggled with a clear and practical solution, but mom, not being too eager to suggest something, waited for a quiet time and wondered aloud a certain solution. Karen agreed, as she often does. She's bright, but coming up with an articulate and a practical solution has sometimes been difficult for her. So mom wondered aloud whether solution "X" might work. They tried it with some success.
The next day mom and dad were going out and a babysitter who had worked with Karen and her brother before was being given the routine orientation for the evening. Karen broke in. "Make sure to tell her about the new solution we came up with!" Mom smiled as she related to me that indeed, she then told the sitter about solution "X" per Karen's wishes. Karen reminded mom, "We need to use it, she [the babysitter] needs to know." The report from the babysitter, not surprisingly, was positive. Karen indeed is doing well.
Kids Do Well If They Can. Yup.
