kids

Video Blog! Helping Children Get To Bed (and stay there) - The Bedtime Pass Technique

Utilizing a Bedtime Pass

A “Bedtime Pass” is a strategy that you can use with young children (approximately ages 3 to 10) who have a difficult time going to bed on their own, or staying in bed once they have been put down. It’s best used with children who do the following things after being put to bed: call out to parents (e.g., “Mom, I love you.” “Can you come back in?”), cry or yell, or actually leave the room.

It is important to note that for children under two or over ten, this may not work.  Also, it may not be best for children who have lots of behavior problems at times other than bedtime. For these children, other things are probably needed first, before working on the bedtime routine.

 

Using the Bedtime Pass is a multi-step process. Below is an outline for your to follow:

 

1)    Sometime before bedtime on the night that you are to start the program, sit down with your child and explain the procedures. These are the important points to cover:

 a.     Explain that your child is having some difficulty going to sleep on his or her own and that you have come up with an idea of how to help. (e.g., “I know that it’s hard for you to go to bed on your own. So, I’ve made up an idea that may help you.”).

b.     Explain the strategy. Say something like, “You and I are going to make a pass for you to use each and every night. You will get one pass per night. After mommy or daddy puts you to bed, you can use the pass for one free trip out of the room, for some purpose. The reason has to be short and to the point. For example, if you want one last hug or one last trip to the potty, that’s fine. If you use your pass, then you need to give it to mommy or daddy and go straight back to bed.” Stress that it needs to be a short, specific reason (5 min or less).

 c. Explain what should happen after your child uses the pass. Say something like, “After you use your pass, you need to go back to bed and stay there for the rest of the night.”

2) You and your child should now make the pass. You can use 3x5 or 5x7 note cards, thick cardboard cutout to about the size of a small photograph, or some similar material. If you used note cards, you might want to tape several together to make the pass sturdier. Allow your child to color, write on, or otherwise make the pass his/her “own.”

3) Just before bed, hand your child the pass and remind him/her of its purpose. Follow your typical bedtime routine and then leave the room.

4) If your child requests to use the pass, allow this and then take the pass. Send your child back to bed, reminding him/her that it is now time to stay in there and be quiet.

5) If your child calls out AFTER using the pass, ignore this behavior. Even if s/he escalates, continue to ignore the behavior.

6) If your child comes out of the room AFTER using the pass, physically guide him/her back to bed with no/minimal interaction.

7) For the first few nights when you are using the pass, remind your child of the rules of using the pass, give him/her a pass, and follow the same routine. Increasing the Success of the Pass: For many children, simply using the pass will be effective in decreasing bedtime behavior problems. Of course, you will want to verbally praise your child for using the pass and for going to bed like a good boy or girl.

For some children, the pass may result in some improvement, but not as much as you’d hoped for. In this situation, you may also need to add an extra incentive for using the pass.

 

Examples might include:

1) Letting your child pick his or her breakfast (within reason, of course) on mornings after not having any bedtime behavior problems.

2) Offering an afternoon/after school treat when your child didn’t call out or leave the room at all.

3) Providing an opportunity to reach into a grab bag with small treats each morning that there was no resistance.

4) For older children, you can make the rewards more long term, like staying up later on Friday if there was no or minimal bedtime resistance during the week.

Remember, if you are offering incentives; make sure that your child only gets them when there is no bedtime resistance. Also, think about providing more rewards at first, and then decreasing the rewards over time.

Three More Bites! End Mealtime Madness and Promote a Child's Healthy Relationship with Food

Written by Kaitlyn Jue and Dr. Elizabeth Adams 

I used to dread lunchtime at school.

Managing 14 young children, the contents of their lunches, guiding them to make healthy choices, and ensuring that they all ate enough seemed like an impossible task to take on at noon every day.

Because it was.

I reached a point where this approach didn’t feel right anymore.

There are many days when after eating part of my own lunch, I realize that I’m not hungry enough to eat all of it. On other days, I eat every last bite. There are days where I intuitively want an apple first, while other days all I can think about is enjoying my sandwich/salad/other “main dish” before anything else.

Children have, and will follow, these same intuitions if we give them the time, space, and opportunity to do so.

Current research suggests that much of the conventional wisdom related to how we interact with kids around mealtime is actually counterproductive to meeting health and nutrition goals.  For example, it is so common to see parents pressuring kids to eat their meals. This can take many forms with young children, but parents often encourage their kids to “take a few more bites,” using treats as an incentive to eat more of the presented meal, feeding kids that are able to feed themselves, or resorting to arguing, bribing, yelling, and even punishment as a means to entice more food intake. This desire to pressure children to eat is generally driven by good intentions of the parent - they do not want their child to be hungry or uncomfortable, and they worry about providing them proper nutrition.  

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A study published in the Journal of Nutrition Education and Behavior found that children who were pressured to eat consumed significantly fewer fruits and vegetables and ate significantly more foods with less nutritional value compared with children who were not pressured to eat.  Ultimately, the goal for our children is that they are able to make appropriate decisions about food independently, and are able to look to their bodies regarding cues about hunger. When parents put too much pressure on children, we aren’t giving them an opportunity to read their body signals, or develop the capacity to make independent choices about food and regulating what they eat.  Battles also result in frustration and negative feelings about food and nourishing our bodies.

Changing our approach

In November of this past year, we worked together to begin exploring what would happen if we released the micro-management of meal times at school. One day, completely “cold turkey,” we stepped back and let our students take the lead.

Using evidence-based practices, our new approach to lunch management empowered the children to make their own choices about what they ate from their lunch, in what order they ate it, and how much they ate.

One common practice around mealtimes is having children eat a certain amount of a meal in order to get a dessert or treat (e.g., “Take three more bites of your chicken then you can have your brownie”).  Nutritionists suggest that this practice encourages kids to be less mindful of what they are eating. Psychologically, it sets up the meal as a “chore” that kids have to muck through in order to earn the “prize” at the end of the meal, rather than teaching kids the value and appeal of a variety of foods, and how to make choices in a food landscape where lots of choices exist.  This is especially important since children have an immense amount of control over their diets as young as elementary school when many of their choices over food choices, the order of consumption, and amount of intake are generally independent.

In our classroom, given our new approach, when a child asked, “How many more bites of [insert food type here] before I can have my treat?” We’d respond with “Listen to your tummy and choose what you think will help it feel best,” as opposed to providing an ambiguous number (“three more bites”), which is what I had done for years.

At first, I’m fairly certain a few of the kids thought I was joking. And, as expected, there were a few students who dove straight for that “treat” as soon as their lunch boxes were opened. But, over time, I noticed my students speaking intentionally about their food choices and intuitive eating processes with increased mindfulness and confidence.

One day, after taking two bites from a cookie, one student shared, “I think my tummy is all done with my cookie today. I’m going to save it for when I get home.”

On another occasion, a different student was trying to determine what she wanted a bite of, she spoke, “Tummy, what do you want? Do you want the mango? Or crackers? I think my tummy wants both so I’m eating them together like a sandwich.”

 

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Helpful tips for managing mealtime (for teachers and parents)

We as adults are often fearful about allowing kids to take more control over their eating because we worry that children will make only unhealthy food choices, or that they will “starve” without the pressure to eat.  Physically “making” a child eat is not possible, and most toddlers figure out very quickly that this is one of the few domains where they have a lot of control. Below are a few tips to help you work with your child in developing healthy eating habits, and making fueling the body a positive experience.

1). Have developmentally appropriate expectations regarding quantity intake. Parents often pack too much food for young children, and then are dismayed when a lunchbox returns home half-full.  Education regarding typical and nourishing amounts and types of food for growing children is an appropriate place to start!

2). Present a variety of foods, including somme options you know your kids will eat. Repeated exposure to new and healthy foods is key!  One aspect parents can control in many mealtime situations is what food is offered.  Focus on offering a variety of options, and give your child the control is choosing which of the foods they will eat, and how much of each they will eat.

3). Be mindful of what you focus on. It is far more important to talk about food in terms of fuel, and the positive aspects of different foods, instead of labeling foods as “good” and “bad.”  Use mealtimes as a time to also focus on connection and being together, and make the presence of your child at a family meal mandatory, rather than making a certain number of bits the mandatory focus.  Encourage kids to listen to their bodies, and recognize cues about hunger and fullness. Praise trying new things and kids expression of paying attention to signals, rather than praising eating certain amounts or avoiding certain foods.

4). Relax! Taking the pressure off takes some getting used to, and can activate anxiety in parents and caregivers.  Rest easy that children may learn from a natural consequence of being hungry if they choose not to eat at dinner (tip:  set the dinner aside for later, or keep fruits and veggies on hand as “anytime food” if they indicate their tummy is telling them they are hungry!). These learning experiences of cause and effect will help them to grow and understand how to read their body’s cues, and respond accordingly.

For more tips on developing healthy eating habits at home, see our evidence-based infographic below:

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Mealtime should be a positive experience for the family; one that is focused on fueling bodies, and connecting over a conversation and a shared meal.  In the landscape of “picking battles,” micromanaging food intake is likely a smart one to give up - and you may be pleasantly surprised by the outcome.

Remember that what each child needs is different.  Dr. Adams provides individual (Skype or phone based) parent coaching to address a range of concerns (e.g., sleep struggles, tantrums, limit testing, co-parenting issues).  Email Dr. Adams for more information, or to schedule an appointment at dradams@personalizedparenting.org, or learn more here:  www.personalizedparenting.org.

Quick Tips: 5 Evidence-Based Tips to Avoid Mealtime Madness

Quick Tips!  How to avoid mealtime madness.  Evidence-based tips and tricks to save your sanity at dinner. 

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Remember that what each child needs is different.  Dr. Adams provides individual (Skype or phone based) parent coaching to address a range of concerns (e.g., sleep struggles, tantrums, limit testing, co-parenting issues).  Email Dr. Adams for more information, or to schedule an appointment at dradams@personalizedparenting.org, or learn more here:  www.personalizedparenting.org.

Dr. Adams Answers: How do I respond when my 3-year old reports a peer is being unkind to her?

How do I respond when my 3-year-old reports a peer is being unkind to her? 

Q: I’m hoping you can give me a little advice on our first little social road bump.

My daughter goes to a preschool with 8 kids in the class. She is the youngest by quite a bit. Everyone except for one other girl will be four by the end of October. She can totally hang academically, and her teacher says she’s pretty close socially, but to me, she seems less mature.

So, in the last two weeks, when I ask my daughter what she did/who she played with at school, she will mention some not so nice actions of a friend of hers—nothing crazy, typical three year old stuff. She always tells me these things in a nonchalant way and doesn’t seem upset. She’s said that the girl has said things like, “if you play with her I’ll push you over” or my daughter will say that she likes to play magnets with her, but the little girl won’t give her any of the magnets. Tonight she told me that the girl wont play with her “because she doesn’t like me”. I tried to ask her why she thinks that but couldn’t get an answer, and I didn’t want to put words in her mouth. I’ve tried to keep my responses nonchalant since so far she hasn’t seemed upset. I don’t want to give her reason to be upset if she’s coping well. I’ve just said things like “well that’s not very nice. You can tell her that you don’t like that and then find someone else to play with.”

I also feel like when kids do this, it’s a power thing. So if she starts showing she’s upset by the girl, it gives the girl power and might make it worse. But I don’t know. What do you think? Do I let it go and assume like all things with three year olds it will resolve itself? Just keep giving her scripting? Have some one on one play time with the little girl outside of school?
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A: It is difficult to hear

about kids being unkind to one another, and especially hard to hear about someone being unkind to our own child (that Mama-bear instinct is REAL).  

 

 

You are totally right, however, that it sounds like pretty normal, toddler-like social aggression.  These situations are always tricky because 1). it is hard to know exactly what is happening since we are not there and 2). what I would suggest depends on the frequency and severity of what is happening, and what it looks like in context (do they ever play nicely together?  Does she sometimes say nice things too?). 

I think the AMAZING news here is that your daughter is coming to you and telling you about it!  That is indicative of wonderful regulation, and is quite socially developed for her age.  While she may not totally understand what is happening, she is bringing this to you as a way of processing, and because she trusts you can help. It is also positive that she doesn't seem very upset - what excellent resilience!  She isn't refusing to go to school, and it doesn't seem to be dominating the content of her day, so that is also good news. 

I think most of what your gut is telling you is right - you don't want to make a bigger deal than necessary, but there are also some things you can do to help her navigate these moments:

1). I agree, don't blow it too far out of proportion (which, you aren't).  Try to avoid asking leading questions (e.g., "Was anyone mean to you today?").  Instead, start with "Did you and (friend) have any fun together today?" - you might get a sense if there is more balance.  If she brings up a hard moment, then absolutely discuss it with her, but find other things to discuss about her day as well.

2). If/when she brings up a moment where a child is being unkind - validate the feeling she expresses (or seems like she is feeling, if it's clear): "It seems like that might have made you sad, that would make me feel sad too!" If it is unclear how she felt about it, ask her how that made her feel, and validate from there. I would also make sure to praise her for telling you - "I am so glad that you told me what happened so I can help you."

If she doesn't talk about her own feelings, you can model what your own reaction would be - "That would make me feel really sad if someone said that to me." 

Next, help her come up with a plan - "let's think of some things we can do if that happens again." I would limit it to two strategies at a time. Here are a few:

1). As you suggested, encourage her to tell her friend "I don't like that," and to then find someone else to play with. 

2). Give her a different script to try - "I want to play with you, but when you say that it makes me feel sad.  Please don't say that again (or, please share the magnets)." 

3). Tell her if she feels really sad, or if the peer won't stop using unkind words, she can ask a teacher for help. (They are young, and this is age-appropriate). 

From here, check-in with her, gently.  If you ask about it directly (which is fine), just balance it with other questions.  If she brings it up, focus on the positive of her telling you, how she felt, strategies she tried or didn't, and what she could do next.  Role-playing the situation might even help her use one of the strategies in the moment. 

If your daughter is open to it, the idea of having them play together outside of school is a great suggestion.  It might give you some insight, and it might make things better at school. 

If your daughter seems to be getting more upset about it, or the strategies aren't working, (or you have other concerns about the social environment), it is appropriate to talk to the teacher.  

There are some wonderful books for young children that explore social aggression.  Here are some suggestions:  Chrysanthemum, The Recess Queen, and Llama llama and the Bully Goat. 

One thing I try to remind myself in situations like this: while it is tempting to remove the environmental circumstances that are causing the distress (or making something hard), hard situations are unavoidable, and can be an important opportunity for growth for our children. Empowering our kids with these skills and strategies (and safe place to discuss and develop them!) is SO important.  And while they feel (too) young to be dealing with this - it is normal, and there is a gentle and age-appropriate way to help them develop skills they will continue to needs for a long time.

Remember that what each child needs is different.  Dr. Adams provides individual (Skype or phone based) parent coaching to address a range of concerns (e.g., sleep struggles, tantrums, limit testing, co-parenting issues).  Email Dr. Adams for more information, or to schedule an appointment at dradams@personalizedparenting.org, or learn more here:  www.personalizedparenting.org.

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Remember that what each child needs is different.  Dr. Adams provides individual (Skype or phone based) parent coaching to address a range of concerns (e.g., sleep struggles, tantrums, limit testing, co-parenting issues).  Email Dr. Adams for more information, or to schedule an appointment at dradams@personalizedparenting.org, or learn more here:  www.personalizedparenting.org.

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Remember that what each child needs is different.  Dr. Adams provides individual (Skype or phone based) parent coaching to address a range of concerns (e.g., sleep struggles, tantrums, limit testing, co-parenting issues).  Email Dr. Adams for more information, or to schedule an appointment at dradams@personalizedparenting.org, or learn more here:  www.personalizedparenting.org.