Tuesday, August 31, 2010

There Was A Little Girl

The other night, JoyDad and I got to spend some quality time with Joy. Rose was off with friends for the whole evening, and Joy was delightfully happy, and playful, and interactive. At one point JoyDad sighed and turned to me and said, "When she's being sweet, she's just so sweet!"

Which was funny, because I'd already been plotting a post around a rhyme I'd remembered from my childhood:

There was a little girl,
Who had a little curl,
Right in the middle of her forehead.
When she was good,
She was very good indeed,
But when she was bad she was horrid.
-- Henry Wadsworth Longfellow

Masterful use of slant-rhyme (forehead/horrid) -- I guess it makes sense that it comes from a master, though I hadn't known it was Longfellow's work until I went looking it up for this post!

Not that the concept of being good doesn't set my teeth on edge. Sweet behavior and core "goodness" are very different things, and we conflate them at our peril. It's even worse to assign good and horrid intention to a child whose behavior is surely coming from causes we don't fully understand...

I gotta say, though, Longfellow's little ditty captures something of the contrasts we've been living with Joy lately.

When we're having our good moments, she lets us record her singing, and then sings along again and again as we play it back! She smiles, she giggles, she initiates interactions, she's truly a joy to be with.

The bad moments lately, as I mentioned in my transition post, are rather scary things to have happening as we head toward kindergarten: head-banging, and hitting and hair-pulling.

Take Saturday, for example. Saturday afternoon Joy got up happy from her rest, and we went to a gallery opening. (Elites that we are.) Actually, it was a home-grown art show, engineered by an enterprising mama who'd been doing a home-based art camp for her daughters and then displayed the results on the walls of their home and made an event of it. The girls are in the same grades as Rose & Joy; the older one is on Rose's soccer team, and the younger will be in Joy's kindergarten class. So far, Joy is the only classmate that younger-daughter knows, and the family has been capitalizing on the fact that there'll be at least one familiar face!

Joy was willing to let me lead her around as her classmate-to-be proudly showed off work. Then we found some Joy-appropriate toys in the play room where she happily settled, despite rather a crunch of other kids romping and making noise. She loved the snacks: crackers! blueberries! grape tomatoes! We ended up staying for almost two hours, with nary an outburst or protest in sight. (OK, she did make one break out of the yard to try & play with a sprinkler on the other side of the cul-de-sac. But other than that.)

This was a different girl entirely from the one her morning autism-therapist encountered. Joy gave him one of the roughest sessions she's ever thrown at him -- he's usually a favorite for her. He could hardly make the slightest request of her without getting an over-the-top frustration reaction. Several of these involved Joy getting down on her hands and knees and trying to pile-driver her head into the floor.

The head-banging. Oh my, the head-banging.

We have a whole bag of calming tricks, which we shared at a meeting with her school team yesterday. These include:
  • singing
  • soft calm talking
  • slip a pillow or thick quilt under her head
  • change of activity / distraction
  • silly/fun people games
  • glider rocker
  • Baby Einstein MP3s/CD
  • change of venue
  • sit in highchair
  • chewies
  • pillow squishes
  • bouncing on therapy ball
  • back off / alone time
  • pressure to the head / body-sock on the head

We've been trying very hard to take a thoughtful approach to this, trying not to panic, working to figure out the behavior and keep things from escalating, praying that the switches will slide sooner rather than later. From a behavioral perspective, the headbanging does seem to be a frustration reaction, even though sometimes it doesn't take much to set it off. ("Okay, Joy, let's go potty now"... BANG.) We also suspect there's a big sensory component. Some pressure -- quite a bit of head pressure -- feels good. We'd like to get her to choose other forms of expressing frustration, such as pressing her own hands to her head, or stomping her feet.

Of course the question of a helmet has come up in our thoughts. How could it not? There's almost an easy-fix feel to the idea of wearing a helmet... at least keep the wearer physically safe, then we can figure out what to do about the behavior itself!

Alas, this is one of those truly not-simple things. My thinking on the helmet-question has been profoundly influenced by Kristina Chew, who has written a lot about her son Charlie and self-injurious behaviors. Their experience with head-banging in the past couple of years has taken them through full-time helmet wearing at one school, to a much better experience and very-occasional helmet wearing at his current school.

I'm going to quote a particularly relevant paragraph here, from a post of hers that's well worth reading in its entirety:
One thing I have learned from all this is that often the most obvious solutions just treat the problem people see, without addressing the deeper causes. Thus did the school district (and their lawyers) insist that Charlie wear a helmet. But that blue plastic apparatus has been the equivalent of a putting a band-aid on something serious that requires much more examination. The "protection" offered by the helmet was limited at best. As Jim and I predicted, Charlie banged his head harder while wearing the helmet (which makes for really big holes in the walls). He probably started banging more while wearing the helmet (in part due to the discomfort of the thing?)

Joy hates having things on her head. Won't wear hats, won't wear headphones, no earmuffs, no sunglasses. We're lucky that she is willing to accept a hood on her parka, because winters can be brutal around here.

Imagine the frustration level that could be caused/escalated by forcing Joy to wear an apparatus on her head -- when she's frustrated!

No easy answers. Fortunately the good times far outweigh the horrid, even if we spend a disproportionate time agonizing about the rough stuff.

Onward to kindergarten. Our little girl has her first day tomorrow, at a public school with a fine reputation. We like what we know of her team so far. Ready or not, here she comes. Keep thinking those good thoughts for us!


AuntieS said...

I look forward to hearing all about Joy's first day of school! I am curious to see if the head banging issues occur in school as they have been occuring at home recently. It is possible that she may act in different ways in that setting than at home. I also wonder if some of these new and difficult behaviors you have been observing in Joy are somehow related to such impending changes in her daily routine and life and maturity and all. She had made so much progress forward in many areas, rather quickly, and perhaps things such as head-banging are some internal response to that. It would seem, logically, that she wouldn't feel stress or frustration about such positive growth and development, but I sometimes think that there can be feelings of stress, internally or subconsciously, even when changes that take place seem to be positive. Anyway, I hope Joy enJOYs her first day of school. I also hope that Rose continues to feel some excitement and pride to be sharing her schooling with her little sister!! Please give both girls a hug from me before school!!!

Anonymous said...

Good thoughts and then some heading your way tonight. Man, we haven't had a head banging stage, but certainly others that leave us wondering what the heck happened to start it and what do we need to do to truly remedy the core issues. I hope you'll be able to puzzle through soon and that it will be a good first week of school for Joy.

K- floortime lite mama said...

Many many many good thoughts headed your way
I really hope you can find a deeper solution
is it a stim - which really is a sensory coping mechanism ?
Greenspan always says - you should not take away a stim - you should replace it
Joymama bet u r shaking your head at my comment saying "Duh .. Miss Captain Obvious" LOL
I bet you have already thought of these things

kristina said...

Just wanted to say we're all with you and thinking about Joy.

Lynn said...

I'm totally with Kristina...unless it becomes concussion territory I would avoid the helmet at all cost. It is totally a symptom of something else...it's a lot harder to find out the underlying cause than it is just to put a helmet on.