Child experts' book offers practical parenting advice

By Mari-Jane Williams

The Washington Post

WASHINGTON — Every parent can spot the potential child-development nightmare: grocery store tantrum, birthday party meltdown or lack of interest in peers. But when can parents tackle a child's behavior themselves and when might it require the help of a professional?

One book, "Is It a Big Problem or a Little Problem: When to Worry, When Not to Worry, and What to Do" (St. Martin's Griffin, $16), addresses those issues.

A group of developmental specialists from Ivymount School's Center for Outreach in Education in Rockville, Md., wrote it to empower parents who might be confused by their young child's development and behavior.

Sharon Anderson (occupational therapist), Amy Egan (teacher and behavioral specialist), Amy Freedman (speech and language pathologist) and Judi Greenberg (occupational therapist) say they believe that young children want to please the adults in their life, and if, for some reason, they aren't, there must be an underlying cause.

The authors offer simple strategies — for children developing typically and those with special needs — to head off tantrums or calm a child who is out of control. Even the big problems, they say, are surmountable.

For those overwhelmed by most parenting books, this one "helps you differentiate your child and see what's normal for that age," said Lynn Balzer-Martin, a pediatric occupational therapist in Bethesda, Md. "It also gives different situations, because children don't always behave the same at school, or at home. ... Your technique for dealing with something may need to vary depending on the setting."

We recently met with the authors to discuss problems large and small, and how parents can cope.

Q: Why is it so hard to tell which problems are big and which ones are little?

Greenberg: The key is how much is it interfering with functioning across the board, not just in a specific environment. A child is perfectly fine when they're at school or home, and then you take a child on vacation and they flip out, well, that's a little problem. You just have to prepare the child more. But if it was across the board, then we're looking at a bigger problem.

Q: Sensory processing issues seem to be so common now. Do most children grow out of them or should parents be more proactive about getting their kids therapy?

Anderson: A lot of people don't really realize that we all have sensory sensitivities. And over time, a lot of times, they get better. But you also learn how to compensate for those. In young children, if there are small, little things you can do and they're not interfering in general with their ability to do what a child needs to do, it's not a real big deal.

But if ... he can't go to that birthday party because he can't stand the smells in the house, he can't stand the noises then yes, you do need to learn more.

Q: How do you know when you're asking too much of a child and when your expectations aren't high enough?

Greenberg: The more we do for them (instead of just helping them), the more they think they're not as capable. So we have to say, "I'll help you, I'll be here if you need help. But we're going to take it little bits at a time, and you can do this, and I'll sit here and help." And as the child does more, they really become more empowered, creating their independence.

Q: Some children act inappropriately in public because of their disabilities, not because of bad behavior. How should parents handle this?

Egan: The biggest thing you can do as a parent is to stay calm and stay focused on your child. What I'm picturing is a raging tantrum of some sort, very explosive behavior: The child is out of control and if you can just keep focusing on your own breathing and get out of the place.

Freedman: I always say that we're going to leave our jobs as developmental specialists and be professional gamblers in Atlantic City because we know when to fold 'em. If 4:30 is always your witching hour, even if we need milk, it's not a good plan to go to the grocery store then.

Q: How can you talk honestly with your child about their difficulties without damaging their self-esteem?

Freedman: Everybody's good at something. I always go personal with that: I'm not very good at directions when I'm driving, and sometimes I'm not good at making new recipes and Daddy's good at this. Sometimes you can show it from an adult perspective. Everybody has things that they are good at and things that they are still working on and this is what you're good at and this is what you're still working on.

Q: What if you have a nagging suspicion that your child has a big problem, but your pediatrician disagrees and wants to take a wait-and-see approach?

Anderson: A parent's suspicion is a strong thing. If a parent is having that feeling, there's probably really something. But if you've got a 1-year-old or an 18-month-old who's not quite walking and you're a little worried because your friends' kids are walking, that's one that you might just want to give it a little more time.

Greenberg: In fairness to pediatricians, they're seeing them in a one-to-one situation. They're not really seeing them in their natural habitat. ... When you put them in the mix of the group setting and all the demands that you put on them, that's where you see them having struggles. So erring on the side of getting some help is never a problem, and I think the parents are the best judge of that.