A question that I’ve noticed coming up fairly often in the SM facebook groups I’m part of, relates to how to help your child when meeting new people in public such as shop assistants, doctors, bus drivers, child’s friends’ parents. I often want to reply to these giving tips but don’t always have time, so thought I’d do a generic article here that I can refer people to. I actually started out writing a blog post for all of the above scenarios, but it was too long. So today I’ve broken it down into this one subcategory of interactions. The way you help you child to interact with adults who s/he is not likely to ever meet again, or form an ongoing relationship with is different to the way you approach their relationship with their friend’s Mum, their GP or dentist for example. These tips are for brief interactions of a few minutes (such as retail, hospitality staff, friendly people you meet at the park) …… not extended interactions, even if they are a one-off (such as seeing a different doctor to usual or having a hearing test with an audiologist or nurse). Set goals in advance with your child You might say something like ‘You have been doing so well with waving bye at the shops lately. Do you think today you would be brave enough to tap Daddy’s credit card at the check out today?’. Summarise what they can already do and negotiate on an appropriate next step, plus what the reward will be, if there will be one. Have a repertoire of set positive phrases you can use When you are meeting people briefly, then there is no time to explain SM to them and this would probably be quite negative for your child if everywhere you go you are drawing attention to the problem during the exact thing that they are anxious about – interacting with new people. If you are constantly going on about SM then they can internalise that and it becomes such a huge part of their self-image that they can see it as a fixed part of their personality that will never change rather than a temporary problem, which can be overcome. It also doesn’t help to dumb down SM to make it easy for people to understand in a brief interaction, by labelling the child as ‘shy’. Again, shyness is a personality trait, not an anxiety disorder and can be confusing to the child if they internalise it. It is best to use the same positive language in front of the child, when speaking for the child and when explaining the child’s behaviour, as you would use with the child in goal setting at home; so instead of focusing on the problem, focus on the solution. “Josh is working on his brave talking.” For example, if a shop assistant says to your child: ‘Hello, how old are you?’ and you know it is unlikely s/he will be able to respond, then here are a series of steps you can use to keep it positiveand take into account some of the important steps listed later on (take control when required, prompt the child to do something achievable, protect the child): 1. Don’t rescue the child too soon. Wait 5-10 seconds – although it is unlikely that your child will answer, stranger things have happened, allow time for the child to respond in some way. This is a very uncomfortable moment for the other person, for you and for the child. However it is important for you both to work on increasing your ‘distress tolerance’. This may be that special moment where they nod or shake their head for the first time in response to a yes/no question! Sometimes the other person will be so uncomfortable during the silence that they will start to ask more questions, in which case skip straight to Step 2. 2. Use your set phrase. ‘Skye is still working on brave talking with new people.’ Other examples of set positive phrases include statements about what your child is working on. These act as a clear message to the other person not to expect more than this and not to push for more. E.g. ‘Max is working up to talking to new people. We are going to start practising waving hello / smiling / nodding soon’. At that point you may not be offering an alternative way to answer their question, just showing that the child will not be answering, that you are aware that this is unusual and the situation is being dealt with. 3. Prompt the child to complete an alternative action that is achievable for them, if appropriate and possible. This needs to be age and stage of recovery appropriate and be something that they are expecting, working on and being rewarded for. It might be holding up their fingers to show their age, or nodding when you get to the right age. You would usually need to take over the interaction and be a kind of translator for your child. So after your set phrase you might repeat the question yourself: ‘Skye how old are you? Can you show Mummy how old you are on your fingers? Yes, you are four. ‘It can help to slightly turn away from the person and create a bit of a barrier with your body so the child’s response cannot be seen by the stranger. Then you turn back to the assistant and say ‘She is four’. 4. End the interaction on a positive note if possible and protect the child if necessary. Once your child has completed the alternative action, try to signal to the other person and to the child, that this is the end of the interaction (unless they are further down the track of recovery and then if the interaction is going well, you may want it to continue). That way, the other person doesn’t continue to ask more questions where you may not have an achievable alternative option for them. In other words, quit while you’re ahead! It may be something like giving the child a job to do such as loading the shopping, giving them 20c to put in the guide dog collection, giving them an apple to eat, reminding them to ‘be quick because we need to get back in time for….’ or asking the other person how their day has been to distract them from continuing to focus on the child. If the interaction was not successful then finish up with a quick: ‘Well done for trying, we can practice again another day’. 5. Reward the small steps. After the interaction (usually once away from the person), most children like a verbal acknowledgement of their achievement. I’ve talked before about how / when to reward and will again but I can’t cover that here as it would be too long. Some children love effusive praise for their achievements immediately after, others find it extremely embarrassing and don’t even want it mentioned. For those children, it may be best to not mention anything until a couple of hours later and then in a businesslike way just say ‘We’d better put that sticker on your chart for waving bye to the lady in the pet shop before we forget’ or even just putting the sticker on yourself and write underneath ‘waved bye at pet shop’, casually telling your child that you put their sticker on and that they have X number of stickers to go until they get their Sylvanian Families Bathtub & toilet set. These children may appear as if they have no interest in the sticker chart until they get the end reward but are often secretly proud of what they have done. N.B. Young children will require an immediate reward and may not be able to relate that the sticker they will get will ultimately lead to something bigger. Keeping some sparkly stickers in your purse to give to your child IMMEADIATELY after the interaction is good here, and/or you can keep something non-perishable in the car if a physical reward is required e.g. Snake lollies cut up into little pieces in a jar in the glove compartment. **As a side note, if you do not believe in using rewards / sticker charts in parenting, I share your concerns, but when a child has an anxiety disorder, we are asking them to do something which is terrifying for them. They are not going to be intrinsically motivated to change, the whole disorder is about avoidance, so bribery and corruption are really useful. The intrinsic motivation comes later on in treatment. I believe I talked about this in more detail when I was a guest on the Thriving Children Podcast. I should put the link up to that sometime…. It’s also not appropriate to use foods as a reward for children in most situations, but it is warranted sometimes when treating SM. I don’t mean handing your child a chocolate bar every time they high five their swimming instructor, more like giving them one cube of chocolate (as well as their sticker towards new toy/book) for any big firsts. If you are family who avoid sugary foods, all the better, as these items are an even bigger treat and carry a higher perceived value to your child. Again, I share your concerns, we are a minimal sugar household, but a few Freddo frogs are not going to damage your child’s health as much as an unresolved anxiety disorder – needs must! I think I need to do a entire blog post on this….** Set the example Social anxiety is the most heritable of anxiety types, so if you have a child with SM it’s not unlikely that you also suffer with some anxiety yourself, social or otherwise, and this can make these awkward interactions with strangers all the more stressful for you as you really identify with what your child is going through and are also anxious about what any onlookers are thinking of you, your child or your parenting skills. If you are not someone who likes to make conversation with strangers, you may need to set yourself the challenge of increasing your friendly communication with new people in as many situations as possible to model to your child that it is possible to enjoy meeting new people. If your social anxiety affects you significantly, then getting treatment yourself is also going to help your child. Even if you are not an anxious person, supporting your child with SM is a big strain and can bring on some anxiety, especially in these situations where your brain has learned to anticipate stress, embarrassment and worry about your child. Unfortunately, children pick up on EVERYTHING! So I’m afraid you are going to have to fake it til you make it. Try to project an outward aura of calm, assertiveness and approachability. Use deep breaths, grounding exercises, power poses, whatever you have to, to get through these experiences. It is also okay to acknowledge to your child if you struggle with the same things that they do, but make sure you show them a growth mindset and not avoidant patterns of behaviour. They need to see that Mummy or Daddy get scared too, but that they are brave and will do it anyway until it gets easier. You also need to model assertive behaviour for your child. Practising in advance and brainstorming ideas with your partner, friend or psychologist may help with this and with the next suggestion, which is…. Don’t be afraid to take control when required It’s okay to take over and drive the conversation to engineer opportunities for success for your child. It doesn’t matter if you seem a bit weird to the other person. Maybe the stranger has asked your child’s name, they did not answer and you have used your ‘set positive phrase’ (which includes the child’s name and therefore answers the question) but maybe you follow up with your own question that you know / hope they can answer. Pre-empting the next likely question and asking it yourself gives your child the chance to practice answering you in front of the other person, if they can’t answer the person themselves, even if it is just with a barely audible whisper, an almost imperceptible nod or a smile. You can usually guess what people are going to ask; with little kids, people usually follow a format – name, age, what did you do today, question about something they are carrying / wearing / eating e.g. I like your T shirt / do you like Peppa Pig? / That looks like a yummy banana / Is that your baby brother? What’s his name? / Would you like a sticker? / Would you like a balloon? Are you allowed a ….? Set them up for success Don’t set your child new challenges when they are tired, hungry, unwell, or particularly anxious. Don’t prompt them to interact with someone who looks like just the kind of person who will trigger their SM. Let them hide behind you this time. If they’re in a great mood and pumped to try something new and then they fall over right before, take a break to fully recover before you attempt it. Going through the check out and they are all set to try to ‘wave Bye’ for the first time? Choose your lane carefully. Look for someone who looks gentle and approachable. Try new things when they are on a natural high after confidence boosting and anxiety-calming exercise. Keep goals age and stage appropriate You can’t just go from diagnosis in a young child, to setting a goal of waving to the check out guys. A newly diagnosed three year old with moderate to severe Selective Mutism is likely to still be clinging to your leg every time you leave the house or hiding under tables at birthday parties (if they can even be persuaded to go at all). Waving hello to the host of a party or making eye contact with the guy on the check out may be simply too big of an ask. Work out where they are now and set a goal that is achievable for them. It might be something as simple as “When we are the shops you need to practice being brave by letting go of Daddy’s leg. You need to walk next to me and hold my hand.” In a child with super high anxiety, it may be appropriate to shield them from interactions with strangers and talk for them whilst whatever you are doing to lower their anxiety in the initial phase after diagnosis takes effect. You might set the goal of them walking beside you through the supermarket aisles but allow them to hide behind you at the checkout, or use your body as a barrier to discourage the checkout person from initiating conversation. If however, they are at the stage of whispering a few words to their teacher when no one else is listening and talking to one or two friends out loud in the playground; then it is not appropriate to avoid taking them to places and putting them in situations where people will ask them questions. Protect the child from people who come on too strong or who are negative / shaming Some people mean well but are just insensitive or have poor social skills and may not pick up on or accept your cues that you do not wish your child to engage in a social interaction with them. You don’t know what is going on in people’s lives. The person who wants to pursue the contact may be very lonely and be delighted to have the chance to speak to people when out and about. A lot of people just really love kids. This is a particular problem of middle aged women who are parents of grown up / teenage children….they think they know how to relate to all children, they miss the time when their kids were little, aren’t yet a grandparent and can take ‘getting this 3 year old kid whose Mum says he doesn’t talk to strangers, to open up to me’ as some kind of personal challenge, either that, or they like to give you lots of advice on how best to deal with the situation! You also need a back up plan to deal with idiots. These are the kind of people who in spite of you using your ‘set positive phrases’ don’t take the massive hint that this child has a diagnosis and think that your child is rude, ill disciplined and that you are basically a rubbish parent. You cannot win with these people. The best thing to do is get as far away from them as quickly as possible. It is extremely upsetting to be judged like that, but you need to put on a brave face for your child and talk to another adult about it later or have a cry when they are not looking. Your child is already fearful of strangers and having attention drawn to their not speaking. Then a stranger starts to judge them, or tries to force them to speak. If that stranger judges their parent, and is in a negative interaction with their parent then that is like their worst nightmare. If you react strongly and give that person a piece of your mind, it is just going to add to the stress for your child. You need to end the interaction in a calm and assertive way that lays down boundaries and shows your child that you will protect them. This is where having some one-line retorts come in really useful, start out gently and gradually increase the severity. Some ideas of things you could say include:
With very young children, you can use deliberately complex words quite quickly and quietly so that they don’t really hear or understand what you are saying such as ‘I don’t appreciate your interference, there is a medical diagnosis in our situation.’ If the stranger does not react to the word diagnosis or anxiety, then they are just not going to get it. More often than not when you come across an idiot their judgements will be non-verbal or passive-aggressive, such as sighing loudly, tutting, staring or commenting to their friend just loud enough so you can hear. Hopefully, a young child will not notice or can be easily distracted, so it is best not to engage with these people so that your child continues to be blissfully unaware. Remember that it does not matter what the stranger thinks of you, or your child, it only matters that child does not become even more fearful of social situations. It does not matter if the stranger makes any kind of unfounded assumption about your child or your family. It does not matter if they feel like they have ‘won’ because you did not react. It only matters that you can make your child feel safe and protected in that situation. Luckily these people are few and far between, but being prepared with a quick response can shut them down rapidly and defuse the situation before it damages your child’s confidence. Be prepared to walk away, even if it inconveniences you significantly, e.g. walking out of doctor’s waiting room “to go to the toilet” (risking being called while you are gone) if another waiting patient is commenting on your child. You are more likely to get a reaction from this kind of idiot if your child externalises their anxiety with bad behaviour. Most SM kids are too anxious to externalise their anxiety through acting out, but I have had one of my girls be like this when she was 2-4 years old, whilst she was a bit young to have insight into her own anxiety and particularly before we knew what was wrong, as we inadvertently made things worse! I know that it is hard, but try to keep your response to your child consistent with what you would do if no one were watching. Don’t change your response to placate other people. Zone out other people and try to respond in the moment. Your parenting is the sum total of a lifetime’s work and is not encapsulated in this one moment. Manners do cost something Just a reminder…the words please, thank you, hello and goodbye can be extremely difficult for kids with SM, even once they become verbal. By the time they are diagnosed they have been pressured hundreds or even thousands of times by their parents and other adults to ‘say please and thank you’. Even where everyone is quite sensitive to the fact that it is normal for young children to be shy around strangers, we do tend to think that they should at least say Hello, Goodbye, Please and Thank You. Other people also often think this; they might say: ‘Are you shy? That’s okay, I was shy when I was your age, you’re only little!’ and then two minutes later say ‘What do you say? Mind your manners!’ when they give the child something and don’t get a ‘Thank You’. This is an awkward moment for everyone because the social contract of basic politeness has been broken. I find that when your child has perhaps said a word or two or has had some kind of non-verbal interaction with a person but can’t manage to say thank- you or goodbye, a pre-emptive strike is helpful. I would personally be effusive in my thanks to the person to show that I have manners and am modelling manners to my child, I would also reply on behalf of my child ‘WE really appreciate, don’t we?’ Big smiles from you go a long way. They might be at the stage where you can say ‘Give the lady a big smile to say thank you for the balloon’ or ‘Can you do a little wave to say thank you and goodbye?’ or ‘Give the man a thumbs up to say thanks’ or ‘Can you whisper thank you in Mummy’s ear?’ and then saying ‘Well done! She says thank you’ (even if she just made a tiny noise in your ear). You know your child best and will work out over time which things are harder for them. For some kids it is the eye contact, so they might do a halfhearted wave without looking at the person. That is okay, at least they waved, praise that! When waving is easy and routine, then work on the eye contact. Maybe the word bye will come before the eye contact; whatever order it happens in is okay. Other children hate making gestures or signs. They might give a lovely smile but not be able to wave goodbye. You have to be flexible and adapt to suit your child’s strengths, weaknesses and triggers. Comments are closed.
|
SUSANNAH BAdelaide Hills Postnatal Support Specialist CATEGORIES
All
|