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I just started my pedi. rotation and I have not had fun. We are going to a place called Challenge Child, it is a daycare that allows special needs children to come in along with the typical children. Just let me tell you we walked around and helped with lunch and those kids have problems. This one little girl ran up behind one of our students and bit her. I am scared of this girl. I don't think I have ever been scared of a 4 year old. The same little girl, while a student was helping her to eat, she rared back and slapped the student and it was not expected. These children are from 0-6 years of age. Our instructor said this was a time to relax and learn to be a child again and learn how to play. I don' t know about you, but I have a hard time playing with these children when they seem they have no respect for the elder. Maybe some one can give me advice on how to handle these children and learn how to interact with them

Well, I'm not a peds nurse, but I found a website for Special Needs children you might be interested in.

http://www.specialchild.com/

Hope it helps a little. It may be that they can "smell" your fear. Stand your ground and do try to have fun....like your instructor said. Also, if they think they can get away w/it, they might try it again.

I have a cousin that has cerebral palsy due to a problem w/his delivery.....hypoxic. His behavior is pretty good now at age 25, but I remember him throwing tantrums when he was a child....I'm thinking it was out of frustration. He has mild retardation too and had a very difficult time communicating. He would get so worked up that nobody could calm him down.

Just try to be understanding and patient.....not fearful.:)

I agree with KC Chick I work in a children's hospital and children defintely can see when someone is afraid, nervous and scared and everything else in between. They also know when you are happy and you want to be there. I also use to work in a childcare center and some of the kids their were special needs.

Some children are difficult and those who have special needs it is even harder. It takes a lot of patience. It is not going to be easy.

When you say these kids have no respect for the elder. Some of them really do but they don't know you and once they see what you are going to do and get to know you then they will understand.

Some kids will test you and want you to earn their trust.

As far as biting some kids do have a problem with that and for most it is simply a stage they are getting through. If you jump back and get scared out them they will be afraid and their behavior will get worse.

There are no easy solutions here expect say Hi how are you my name is ___________ what is yours? Ask them how their day has been so far. Find out what they like to do? Have diversions for them if they are allowed such as crayons and coloring books. Also bubbles are a big hit with children where I work. They love bubbles so if possible carry around some bubbles and start blowing bubbles.

These children want to play and once they see you are not afraid they will calm down and warm up to you.

Make sure you are down at their level don't have them look up at your level. You may already know that but I can not tell you the amounts of times I have seen parents, childcare teachers and even some nurses at work who do not get down to the level of the child to speak to them. That is very intimidating to them.

Every once in a while you will have that difficult child who refuses to cooperate no matter what but you do your best. AT the same time keep in mind the environment the child may come from. The child may come from a good, loving envirnoment or the child may come from a totally different envirnoment and please keep that in mind because many times some of the children who do the things you described are simply looking for affection and attention but don't know the proper way of how to go about it because of their home life.

Specializes in ER.

The biter needs a quick time out supervised by the bitee. Some things aren't acceptable no matter how disturbed or frustrated you are.

Now, I may be overstepping my boundaries here, and I am sorry if I am but I feel I have to put my 2 cents in.

The other day, my husband and I were walking around one of those huge "superstores" and we heard a child screaming and having a fit! I figured, well, most kids are going to do that sometimes, and I tried to ignore it. But a half an hour later, I turned to my husband and told him to get me out of there before I hunted that kid down and busted it's behind myself! I am the mother of 9 children, ranging in age from 21 down to 7, and NOT ONE of my children ever threw a fit like that in public! (Oh! Excuse me... my 21 y/o daughter did a couple of times when she was about 3-4 and was spanked on our way out of the store each time.) As we were waiting in line to pay, the child and his mother walked by with him still screaming (he was about 5, I'd say) and he was KICKING his mom with almost every step he took! She turned around and told him, "Now stop kicking me and biting me... that hurts!" Did he stop? No.

Now if that was one of mine, I would have calmly left the store and proceeded to bust a bottom end all the way home. I don't think there was anything mentally wrong with this little boy except he was a demanding little tyrannt who was used to getting whatever he wanted.

I also am a Sunday School teacher and the children know what they can and cannot do in my class. They know who the adult is...when did we lose control? I agree with canoehead... time out by the person who was bitten seems a good solution to me.

Show authority to these children, or they will run over you every time! And believe me, I am not above a swat on the behind of a child in my class if they need it. Shoot! As a matter of fact, the parents usually appreciate it! They know the kids aren't running wild in Sunday School!

Sorry to have rambled on so, but unruly children just strike a nerve with me. Sometimes I think the parents need a smack or two also for letting it get so out of hand!

Thanks for letting me vent you all!

*PHEW!* I feel better!

Julie:)

Julie I understand what you are saying. My child test me all the time and she will end up throwing temper tantrums like you won't believe sometimes in the worst place possible like the store. She is at the stage where everything she sees she wants me to buy. Do I buy it for her of course not. But it makes it seems like I am a bad mother when my little girl throw temper tantrums when many, many child experts and pediatricians will say that temper tantrums are normal for young children.

I do agree with you. I just think that the parents of these children should be looked at and what type of envirnoment these childern come from because I have dealt with several children who are really innocent children and you can't blame them due to the actions of their parents. Children get their behavior from their parents.

I could never swat a child. Not to say you are a bad person for doing so because I think a child deserves a swat or two every once in a while when they decide to act up but I could not do it because legally I would lose my job and in my state it is consider child abuse to even simply swat a child that is not yours and you can go to jail and never work with children again including facing the possibility of having your own children get taken away. I seen it happen to 3 teachers when I was working in a child care center.

But I do agree discipline is lacking Now days and I am forever working with my child. My child respects others her teacher say she is really great and the best behaved child of all the children in her class expect when she is tired then she is grouchy but it is me that she tests but we are really working on that.

Julie, I find it absolutely AMAZING that you have raised 9 children. I'm giving you a standing ovation right now. (Can you picture it???)

Anyway, it reminded me of a similar "scene" that I observed about 5 years ago in a local mall. A mother was standing in front of a cookie shop w/her two young boys. They looked to be about 4 and 6 y/o I think. The youngest of the two decided that he wanted a different cookie than what he had just ordered a minute before. When his "mother" was handing him this cookie, he said "No, I want a different one!". Mom said "This is the cookie you wanted, this is the one that you are getting". (Something to that effect....it's been awhile.). This child then decides to KICK mom in the leg. Any guesses as to what mom said then????

"If you do that again, I'll take away your Nintendo." That was it!!! Had it been me, the little bugger would NOT have gotten his cookie, would NOT have had Nintendo at home, and would NOT have been able to sit comfortably for a few hours.

I wasn't too harsh, was I???? ;)

Specializes in ER.

I would have put the cookie in a bag, grabbed the little bugger by the hand and taken him to a dark corner for a discussion on how little boys who kick not only do not get cookies, but do not get to go to the store at all, and do not get dessert when they get home. And how they know better and had better shape up and behave like an angel for the rest of the trip or it will be a spanking they get once they get home.

I really wish a family friend of mine could read this thread... Her three and a half year old son is just so incredibly wild - hits, kicks, screams and bites and has often gone for a good grip at the throat! She tries to punish him by saying that what he did was wrong, but then lets him watch a cartoon or video of his choice. But she still can't figure out why he acts out so much! I may not be a mother, but even I can see that this tactic isn't exactly teaching him anything!

My mom used to always say that there is a good reason little kids have such padded behinds...

oops.. sorry - guess I wandered from the main point that I meant to make: From my experience, I agree that little kids can literally smell fear or any kind of discomfort around them. If they know they can get away with something, they will do it over and over again. You need to keep your cool, but let them know when they do something that's not acceptable. I agree that you should kneel down to their eye-level and say: "You just bit someone. That hurts people and you can't do that anymore." Ask them to repeat what you said. Give a time out if you're allowed to, and then try to occupy the kid. Get him or her involved in a game with the others and eventually most will learn the boundries of what they can and can not do.

I am so glad, actually that you had this experience. I was a pediatric RN for many years and one of the major problems we had were new staff who chose Peds "because I love kids so much". It can be a very disheartening challenge to find out that the children who populate a pediatric hospital are not all like your own or your niece and nephew. Many frequent fliers have complex mental and physical disabilities and all of the behaviors you described were commonplace in my experience.

You can love pediatrics anyway but it is great to have a realistic view. I applauid whatever instructor set up that experience for your class.

tempting thread and couldn't resist

being in a day care serving kids with special needs is just challenging and a little worrisome. I worked doing CM with special needs kids and the whole experience was emotionally difficult. I was eternally grateful for my "normal" child and constantly aware of how his situation could change at a moment's notice (head injury). Being around special needs kids is bound to evoke a panopoly of feelings ranging from: revulsion, anger, frustration, anxiety BUT also JOY when you learn to gear your expectations accordingly and see a child mastering a new skill, WONDERMENT when you perceive the intensity with which a lot of these kids persist and try to interact with their world in spite of the odds, AFFECTION, RESPECT for colleagues and professions who work with these children willing to accept the incremental gains that can be made. While it is easy to stand in church or in a supermarket line and be sucked in by the beguiling baby or charming toddler (in a good mood), in general, it takes a little longer and a willingness to see beyond the exterior with special needs kids. Sometimes that means you just have to put some time in.

Special needs kids have often been raised in isolation by loving parents who shaped the world to their needs. If Barney calms them, they get Barney no matter how sick the rest of the family is of Barney. If they need quiet, they get it. If they need therapy in a city 100 miles away once a week, the rest of the kids climb in the car and do that. Day care is a literal assault on their senses and an introduction to getting along with others in the world. Very new and very challenging for all involved. Interventions for the biter have to be firm and consistent with societies norms ("We don't bite others.") But the interventions may need to be uniquely suited to the child. When does he bite? What might set him off? What are early warning signs? How can the adults learn them and "head off" biting incidents and, in turn, teach the child to recognize when his frustration level is being reached? How best to teach that to a special needs child who is over whelmed by his environment? Special needs kids have more and unique needs for socialization.

RE: tantrums in public, which is a separate subject. When a child tantrums in public, parents have got to be willing to hold the child accountable and this often means interrupting what they want to or need to do, which is shop. A screaming, out of control toddler needs to be removed. Period. The parent may elect to remove them to a bathroom, the family car, or home depending on how escalated the situation is. WHen children do not get held accountable for their tantrums, they come to view tantrums as a good way to get what they want. I agree that far too many parents "give in" to their children in public because of their own convenience or personal wants or needs.

JCTHOM, sounds like this might have been your first experience with special needs kids. Examine some of your feelings. I would guess that they are experienced by your colleagues also. Examine your expectations (fun should by a by-product of your experience, not a main expectation). For some of us, special need kids are equated with "failure" of the medical model and I think this is hard. Try to tap into the compassionate part of yourself. Imagine being a toddler (either developmentally or chronologically) and having fewer than normal coping skills. Imagine being constantly over stimulated by this new and unfamiliar environment and just simply having no coping skills. you are frightened by your behavior, but don't know how to stop it. I have seen all of that and more in special needs kids. For now, just experience your feelings and then ask those day care providers (who hopefully have some special training) what they see going on here and what their goals are in responding to anti-social behavior in a special needs kids like biting. Ask them how long the kid has been in the day care and if things have gotten better or worse for him.

At one level, the "costs" associated with an aggressive need to "save every child" in the medical sense are seen when you are in a special needs day care. The family lives with the child daily. It's not an easy "assignment".

Good luck.

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