Happy Kids

by Cathy Glass

  Apart from the obvious sugar-laden foods – sweets, biscuits, cakes and puddings, etc. – sugar is added to many processed foods, and as a result of eating these we have become a nation of ‘sweet tooths’. As well as having physical effects – tooth decay, obesity, diabetes, high blood pressure, etc. – too much sugar can have an effect on mood and behaviour. Most parents have observed the ‘high’ that too many sweet foods or sugary drinks can have on a child – even the average child without a hyperactivity disorder. As sugar enters the blood stream it gives a surge of energy, and the child rushes around on a high; however, after the ‘sugar rush’ comes a low as the body dispenses insulin to stabilise itself. The child then becomes tired, irritable and even aggressive, with a craving for something sweet. So begins a pattern of sugar-related highs and lows. If the child is prone to mood swings or hyperactivity, refined sugar will fuel it. Sugar intake should be moderated and ideally from a natural source – i.e. fruit.

  Caffeine

  Beware of added caffeine. Although it is unlikely you will give your child a cup of strong black coffee, the equivalent amount of caffeine can be found in a can of many fizzy drinks. Caffeine is added by the manufacturers and is a powerful stimulant – which is why many adults drink coffee in the morning to wake them up. Caffeine acts immediately on the central nervous system, giving a powerful but short-lived high. Some bottles and cans of fizzy drink now state that they are ‘caffeine free’, but they are still in the minority, and you will need to check the label to see if caffeine is present, and in what quantity.

  Children’s sensitivity to caffeine varies, but studies have shown that even children who are not prone to ADHD can become hyperactive, lose concentration, suffer from insomnia and have challenging behaviour when caffeine-laden fizzy drinks are added to their diets. Caffeine is also addictive, and many children are addicted (from regularly consuming fizzy drinks), without their parents realising it. The children crave and seek out the drinks, and suffer the effects of withdrawal – headaches, listlessness, irritability – until they have had their daily ‘fix’. Caffeine is best avoided by all parents for their children, but if your child has behavioural problems, particularly ADHD, it is absolutely essential to avoid it. There are plenty of enticing soft drinks and juice alternatives available that don’t have added caffeine.

  Fluid

  The human body is approximately 63 per cent water, and the brain 77 per cent. Drinking regularly, and therefore keeping the body and brain hydrated, is absolutely essential to function effectively. By the time you feel thirsty you are already dehydrated, and even mild dehydration can cause headaches, tiredness, loss of concentration and irritability. Salt is added to most snacks and processed food in high quantities, and salt is a diuretic – i.e. it makes you wee more, which results in dehydration if the lost fluid is not replaced.

  While added salt is obvious in crisps, for example, it is not so obvious in ice cream, bread, breakfast cereals (even healthy ones), sauces, pizza and burgers – in fact many of the foods children eat. Children are more prone to dehydration than adults, as a result of diet, activity levels (fluid is lost in sweat) and the fact that they can forget to drink. Also, the school routine doesn’t always offer enough opportunity for children to drink during the day, with the result that many children become dehydrated.

  Trials have shown that if children take a bottle of water into school, and are encouraged to drink at regular intervals during the day, there isn’t the dip in concentration and learning that is often experienced in late morning and afternoon. The ideal drink for children is water, but if your child really won’t drink water, then lightly lace it with additive free squash or fruit juice.

  Special Needs

  When I was growing up the average person had never heard of ADHD, autism, Asperger’s syndrome, bipolar disorder, attachment disorder, conduct disorder, oppositional defiant disorder or any of the conditions which now seem to be endemic in our children. It would be difficult to imagine that these conditions have suddenly been spawned by a generation, so they must therefore have existed to some extent in the children I grew up with, but without being diagnosed. These ‘special needs’ children were simply acknowledged as being a bit different by their friends and peer group, who accommodated their differences in their social interaction, and by parents and teachers, who gave extra help and disciplined as and when required.

  Diagnosing children as having special needs is now so prolific that every class or random group of children contains some special needs children; many school classes now have upwards of 20 per cent. Special needs falls largely into two categories: those that affect learning and those that affect behaviour. I shall be concentrating here on the conditions that affect behaviour, although the two categories often overlap, so that a child with ADHD, for instance, may also be dyslexic. Having a special needs diagnosis can be useful, in that it opens doors to funding for extra help, both in and outside school, as well as reassuring parents who may have been struggling for years to manage their child’s unusual/challenging behaviour. However, with the diagnosis comes a label, and that label can have a negative effect by tolerating and excusing what would otherwise be unacceptable behaviour in the child, as well as placing a ‘glass ceiling’ on the child’s ability and potential to learn. Parents, carers, teachers and other professionals often refer to a child’s ‘condition’ early on in describing the child, as though it is the single overriding factor, responsible for all the child’s negative behaviour, as if it is a fait accompli.

  Many of the children I have fostered have been diagnosed with a special need that manifests itself in behaviour – ADHD, autistic spectrum, attachment disorders, oppositional defiant disorder, conduct disorder, etc. – and have arrived with behaviour that was completely out of control. Without exception, the behaviour of all of these children improved dramatically, sometimes miraculously, as a result of managing their behaviour, using the techniques described in this book. I am not saying that all the children were diagnosed incorrectly or that the condition disappeared, but that it is important to deal with the behaviour rather than bowing to the diagnosis. Regardless of which special need(s) the child has, if challenging behaviour is one of the symptoms, it can be vastly improved, even completely changed, by enforcing clear and consistent boundaries and using the 3Rs.

  Attention Deficit and Hyperactivity Disorder (ADHD)

  A staggering 8–10 per cent of children are now thought to be suffering from ADHD. Symptoms include:

  * poor concentration, easily distracted

  * difficulty keeping still or quiet, excessive talking

  * disorganised, forgetful

  * always ‘on the go’

  * interrupting and shouting

  * acting impulsively

  * not following instructions

  * easily over-stimulated

  Millions of children (and adults) worldwide take medication to counter the effects of ADHD, with the most commonly prescribed drug being Ritalin. But while medication has been hailed as a saviour by many, a sizeable proportion of those taking it have found that the side effects outweigh the benefit, or that the drug actually worsens rather than improving their condition. Furthermore, data recently released based on lengthy trials concluded that medicating children did not help them long-term but merely masked their problems, and that behavioural management was the way forward.

  I have never asked for any child I have fostered with ADHD symptoms or diagnosis to be medicated; nor would I do so. The children who have come to me already medicated, I have, with the permission of the psychologist and social worker, weaned off the drug. Instead, I focus on clear, consistent and firm boundaries, avoid over-stimulation – for example, excessive use of computer games – and pay particular attention to diet.

  One nine-year-old boy I fostered for two-week periods every couple of months, to give his parents a break, had been diagnosed with ADHD (among other things). He had been medicated in the past but couldn’t tolerate the medic
ine, so was no longer taking it. He used to arrive on my doorstep at the start of his stay like a free radical, charging around and yelling continuously at the top of his voice, completely out of control. By the time he left two weeks later he was a different child, talking normally, listening to what others said and able to sit still and concentrate in order to complete a task. However, within forty-eight hours of his returning home he was back to his old uncontrollable self.

  This went on for the best part of six months, with his mother joking that it must be witchcraft. But it was no witchcraft. During the weeks he was with me I changed his diet, replacing the processed foods and fizzy drinks he had at home with fresh and mainly additive-free food, and put in place clear and consistent boundaries for good behaviour, which I reinforced using the 3Rs. Eventually the parents were so impressed that rather than burning me at the stake, they agreed to try my formula. It was so successful that they never asked for respite again and enjoyed being with their son.

  How many other children with ADHD would benefit from making these changes? We won’t know unless we try. Very gradually the pendulum is swinging towards change in diet, routine and managing behaviour, rather than continuously medicating children.

  Autistic spectrum disorders and Asperger’s syndrome

  These conditions largely manifest themselves with the child having difficulties in social interaction and communication. The child is unable to read or interpret signals from others (e.g. facial expressions), which makes it very difficult for the child to fit in socially. Asperger’s differs from autism in that the child usually has average or above-average intelligence, with fewer problems in speaking or learning. In respect of behaviour, a child with autism or Asperger’s can often become frustrated and angry by his or her inability to understand the social norm, and may appear wilfully challenging when he or she misinterprets signals and instructions and therefore does not do as asked or behaves inappropriately.

  All the techniques in this book for putting in place the boundaries for acceptable behaviour apply to children with autism or Asperger’s; however, the one overriding rule is simplicity. Because the autistic or Asperger’s child has difficulty reading and processing social cues, and therefore understanding what exactly you are saying or asking, it is essential you make your Requests simple, direct and instructive. For example, if you want Aaron to put on his shoes, say, ‘Aaron, we are going out. Put on your shoes now, please.’ If you don’t say ‘now’, Aaron will assume that any time is good for putting on his shoes, despite the fact that you are getting ready to go out. Always state exactly what you want and don’t assume it is implicit in your request or actions. It won’t be. Don’t use satire, metaphors or figurative language, as the child will take it literally. One autistic spectrum child I fostered looked at me most oddly when I told him to ‘keep his eye on the ball’ while teaching him to catch. He had no conception of the use of idioms; and most adults with autism will still struggle when they come across a new way of phrasing something that is not literal.

  Children with autism or Asperger’s thrive on routine and you can use this to your advantage. Put in place a clear, consistent and effective routine, but if you have to alter your routine, warn your child in advance, as otherwise he will become anxious and it could throw him ‘off course’ for the rest of the day. Another simple example: ‘Aaron, you normally get up at seven thirty, but tomorrow it will be seven. This is because we have to leave the house at eight for your doctor’s appointment.’ Tell him in the evening before the change, again as you say goodnight and then in the morning as you wake him, with the added instruction that he has to get dressed now. This won’t necessarily be obvious to Aaron, as the routine and therefore the expectations have changed.

  Making simple Requests, Repeating and Reassuring are paramount for children with autism or Asperger’s, to an extent that wouldn’t be necessary with a child without either of the conditions. The child won’t read or interpret the signals you are giving in the way you intended. If you are in a hurry, upset or tired, tell the child; it won’t be obvious – he won’t necessarily interpret your tears as sadness or your smile as joy. Likewise he won’t automatically know that other people can be affected or hurt by his or her actions, and you will need to explain, probably many times. Children with autism or Asperger’s can learn how to act in social situations, what is appropriate behaviour and how to feel; but they have to be taught it. So say, for instance, ‘Aaron, don’t turn your back on Grandma when she is talking to you. Look at her, please.’ Aaron doesn’t know it is impolite to turn his back on Grandma; as far as he is concerned he can still hear her talking, whether he is looking at her or not.

  I realise that this is an over-simplification, and if you have an autistic spectrum child you will be struggling with very complex, confusing and often challenging behaviour, but my experience is that all children with autism can make dramatic improvements in behaviour with the simple Request, Repeat and Reassure, and of course don’t forget to praise them each time they get it right.

  The child I am fostering at present has diagnosed autism, as well as other conditions. Each morning I lay out his clothes and tell him it is time to get dressed. Once he is dressed I praise him; then I tell him to go downstairs for his breakfast. If I didn’t praise him, he would think he had forgotten something or done something wrong – he needs the confirmation and reassurance. And if I didn’t tell him to go downstairs for breakfast, he would go in his own time – maybe two hours later.

  The child is eleven and has been with me for two years, following the same routine every morning. However, during these two years, as well as teaching him to wash and dress himself, I have shown him how to greet people – shaking hands or saying hello rather than hurling himself at them; how to behave in social groups – when to talk and when to remain silent; taking turns; what is appropriate behaviour; and when and how to express emotion. He still has problems, particularly in relating to his peer group, who aren’t always as patient or forgiving as adults when he gets it wrong. But the huge progress he has made, which has taken him from social outcast to someone who is included, is a result of telling him what is required, and Repeating, Reaffirming and Reassuring until he has got it right.

  Behavioural disorders

  There are two main recognised behavioural conditions: Oppositional Defiant Disorder (ODD) and Conduct Disorder. Both of these conditions are exactly what their names suggest: severe bad behaviour, which can present many challenges for parents or carers. All children display some negative behaviour at some time, but in children with a behavioural disorder it is severe enough to be diagnosed as a condition. The diagnosis comes from the psychologist’s observation of the child – there is no physical test – and the child will display some, or possibly all, of the following symptoms:

  * aggressive towards people and animals

  * frequently argues with adults

  * destroys or vandalises property

  * frequently loses temper

  * actively defies or challenges authority

  * blames others for his or her behaviour

  * is easily angered

  * bullies, threatens, initiates fights or arguments

  * steals, lies, truants.

  Add to this list any other negative behaviour, but to an extent that would not normally be seen in a child without a behavioural disorder.

  An estimated 4–9 per cent of children are thought to have a behavioural disorder, and it is often present with another disorder, for example ADHD. Behavioural disorders can govern and ruin children’s lives, as well as the lives of the parents and the well-being of the family unit. The sooner a child is recognised as having such a disorder, the sooner change can begin. A child who still displays uncontrolled and uncontrollable behaviour into his or her teenage years will be far more difficult to turn around.

  Recognised treatment for ODD or conduct disorder is based on the premise that a metabolic dysfunction has combined with environmental factors (e.g.
poor discipline) to produce the condition. There is no tablet remedy, and treatment focuses on changing the unacceptable behaviour through clear, firm, consistent guidelines, with a system of rewards and sanctions. As the child gradually develops internal self-regulation, his or her challenges to authority will lessen.

  If a child has been diagnosed with a behavioural condition, or you think your child has one from the behaviour he or she exhibits, use the techniques in this book to put in place boundaries, and re-read the chapter on turning around a difficult child. If a psychologist is involved, you will be working together, and you and your child may be offered counselling, which can be a useful source of comfort and support as you journey through this very difficult time. As with ADHD, pay particular attention to your child’s diet, exchanging processed food for fresh, removing as many additives as you can, and if necessary adding an omega-3 supplement. And take care of yourself. It is exhausting and upsetting caring for a child who is continually challenging you. Recognise that and take time out.

  Bipolar disorder

  Sometimes called manic depression, bipolar disorder is characterised by extreme mood swings, where the sufferer can go from being incredibly elated and excited to severely depressed. Bipolar sufferers often become very frustrated and angry, and can direct their anger at their loved ones. It is thought that between 1–2 per cent of the population could have bipolar disorder, and usually the symptoms first appear in the teenage years. Recent research has linked bipolar disorder with ADHD. If you suspect your child has it, then seek medical help.