One of the most common problems associated with the various isms that children may have is – anxiety. Sure, a little anxiety is normal, most kids can be anxious about things. The difference is that in kids with Isms, that anxiety can quickly become lethal. It is optimal to have a plan in place ahead of time to reduce anxiety.
I’m not exaggerating here either, anxiety fills kids up with adrenaline and triggers their “fight or flight” reactions.
When Fight is Triggered
When the kids choose to fight, someone gets hurt, usually a parent or grandparent but just as often, the child with the Ism hurts themselves. Kids who often choose to fight in reaction to anxiety get into physical struggles with teachers, parents, doctors and police. Their sudden movements at inopportune times can cause damage too. Think about what happens if your child makes sudden movements with a mouth full of dentistry tools, or during a haircut – or when confronted by a particularly jumpy policeman.
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When Flight is Activated
When the choice is “flight”, matters are worse. Kids who choose flight often run out of the school gates, into oncoming traffic or into any number of other dangerous situations. If nothing else, they can become “lost” for hours, often in dangerous environments.
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Reduce the Everyday Anxiety
The key to reducing anxiety is “preparation”. If you know that something “different” is about to happen, then you need to get your child prepared.
With verbal kids, this is done by talking about the day ahead and discussing the unusual event in the middle of a “normal day”. Sometimes you need to tell your child, several times over, what to do if they feel overwhelmed or if they get lost. Sometimes you have to write it down for them.
If your child is non-verbal, these concepts need to be conveyed by pictures and/or by “social stories”.
Social Stories to Reduce Anxiety
You can find lots of good resources for social stories on the Internet. Some parents create a social story “keychain” so that they can create a social story “on the fly” anywhere, others use an iPad or android tablet, photos and slideshow software. The best method is “whatever method works best for you and your child”.
The best social stories take the form “this event first, and then…. This event”. It’s important to visually demonstrate the rewards after tough events, such as a dentist, but most importantly, the fact that life goes on and that “normality returns”.
Plan for the Unexpected Anxiety
Sometimes events spiral out of control, become unpredictable or occur without warning. When these happen, the key is still to be prepared.
In these cases, you can’t prepare for specific events but you can prepare your child for moments when they are overwhelmed. Make sure that they have “words to say” or a card to show someone when they are overwhelmed.
Plan for School to Reduce Anxiety
Ensure that the child has a place to go such as a safe meeting point at school. For example:
Instruct the child to show a card to a teacher which allows for the child to go to the school office and show the card to them. This lets the teacher know that the child needs to leave the class while ensuring that they remain in the school grounds, a safe environment.
It also helps if you’ve talked to the school and teachers and office staff in advance. Practice the technique at home and at school with your child and they’ll remember it when they need it.
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Plan for Shopping to Reduce Anxiety
Different places will need different techniques and sometimes you’ll need to plan for vague concepts.
In my youth, I was always getting lost in shopping centres. Partially because I was so easily distracted and partially because, being deaf meant that I never heard my mother calling for me. Eventually we agreed that if I ever got lost in a big shopping centre, I would head down to their centre stage – all shops had them back then. It quickly became a rule and neither my mother or I ever had to panic about my being lost again.
Plan for Police Interaction
One of the other things to practice is interactions with the police and strangers. If your child’s reactions aren’t “typical”, you should consider taking them to the local police station to have their Ism recorded. This can really affect how the police treat your child – once they’re identified of course.
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If you have an older child, for example a late teen, then socialising them directly with the police may be a very good plan.
Roll with Unexpected Anxiety
Sometimes, no matter how much planning you do, there’s just no getting around a major anxiety-inducing event. This is particularly common at the dentist or when undergoing surgery.
Advocate to Reduce Anxiety
In that case, you need to make sure that all of the professionals involved understand that they’re not dealing with simple childhood anxiety. This is anxiety related to an ISM. It can’t be reasoned with and it can’t be bargained with. As a professional, they have to understand that the usual methods won’t work and find another way to get past the anxiety.
When Normal Won’t Work
A good practitioner will be able to gauge the level of anxiety in a child by their reactions to words and concepts. For example:
If a child is having major anxiety about a needle, repeated (constant) discussion of the needle by the child would indicate a fixation. If the fixated child is over reactive to touch, pre-swabbing the area or applying a “test band-aid” most likely won’t work for this child. It’s a good bet that normal procedures will fail because the anxiety levels are too high.
Ward Off the “Barge Through” Approach
Parents need to keep a close watch on these things too because while an empathetic doctor will try to find a way to perform a procedure without elevating a patient’s anxiety beyond tolerance, a “bad” doctor will not. Less thoughtful doctors will simply try to “barge through” the barriers.
If your doctor seems “hell-bent” on getting a non-emergency procedure done in their own particular manner and timing, then you may have to prompt with some suggestions. Suggest using “laughing gas” to reduce the anxiety before going ahead with the needle. Don’t worry if your suggestion sounds silly. It could be a good one or it might be enough of a prompt to get the health care providers to think of some workable alternatives.
No matter what, as a parent, you are the key to reducing your child’s anxiety and making their world safer for them. Set up a plan to reduce anxiety and lower the fight or flight response. Plan in advance for potential situations and have a plan to roll with anxiety when all the planning in the world doesn’t prepare you or your child for an experience.