By Barbara Probst.
Note: This article was first published in Issue 10 of the Twice Exceptional Newsletter (April 2005), seewww.2eNewsletter.com. It has since been reprinted in SPELD News (Specific Learning Disabilities Quarterly, Volume 38 No. 2, May 2006) and Mindscape (Queensland Association for Gifted and Talented Children, Inc., Volume 26 No. 1, January 2006). For additional information, see www.whenthelabelsdontfit.com.
Parents who come to me for consultation and counseling are usually at the end of their rope. They are feeling overwhelmed, exhausted, frustrated, disgusted and distressed at the way their child’s issues and needs have taken over their lives. Schedules, decisions and daily routines all seem to revolve around a difficult child who – despite every accommodation and intervention – isn’t getting any easier to live with.
These are caring, committed parents. They’ve taken their child for every kind of evaluation and therapy but nothing seems to pinpoint the source of the problem or how to make it better. They’ve embarked on a time-consuming, expensive search for an explanation – usually in the form of a label or set of labels –in the hope that it will lead to an effective treatment, a way to fix or at least improve the situation. They’ve followed the “medical model:” diagnose, treat and eventually cure.
Although diagnosis has become more refined – we recognize that there may be a complex interaction of elements, and we can discriminate better between conditions that initially appear the same – diagnosis is not necessarily what’s needed. Many children do things that are odd or excessive, but not all of these things indicate a disorder to be repaired or a deficit to be replenished. The tendency nowadays is to pathologize children, to view any difference or difficulty as a symptom rather than a personal trait. This “pathological lens” isn’t fair to these children; what’s more, it doesn’t help parents deal with them effectively.
A more useful approach is to look at the whole child, at his unique “spreadsheet” of assets and difficulties, as Mel Levine recommends. Each of these traits is something specific – perfect pitch, inflexibility, poor time management, a knack for language, impulsivity, artistic flair, inability to read social cues, and so on. While some of these traits may appear on symptom lists for certain disabilities, the whole child is more than the sum of his parts. And for a child to mature and become integrated, nurturing his assets is at least as important as addressing his weaknesses. In fact, a youngster’s difficulties or quirks may turn out to be his most important strengths. In many cases “problems” occur because a specific trait such as excitability or tenacity, manifesting at the wrong time or to the wrong degree, has gotten cut off from its appropriate context and thus appears as something negative.
Many of the problem behaviors in a gifted child are actually due to exceptional sensitivity rather than to willful disobedience or protest at not getting his way. This may be sensory sensitivity to factors such as noise or texture or the number of people in the room (sensory integration issues), or emotional sensitivity to perceptions of unfairness, discrepancy or insincerity. Gifted children can be acutely aware of when others are being false – when there is a difference between a person’s words and his intonations or body language. The heightened awareness of contradiction (when someone breaks a promise, does something that seems unjust, contradicts an earlier statement, changes a plan or says something he doesn’t really mean) can be unbearable to these children. This can result in behaviors that may look oppositional or rude – refusing to listen, running away, tuning out, becoming angry and defiant, and so on – but are actually coming from the child’s acute sensitivity and inability to tolerate contradictory impressions.
This can also be intellectual sensitivity, when a gifted child who is a divergent, creative thinker becomes so overwhelmed with all the aspects, side-bars, possibilities and implications of a subject that he “overloads.” Conversely, the gifted child who is a deep, intense thinker may become so hyper-focused that he cannot attend to anything he considers extraneous and may become irritable or even explosive if adults try to distract his attention. In all these instances, interventions based on trying to motivate the child to change his behavior (all forms of reward and punishment) fail miserably because the child’s disintegrated state has nothing to do with motivation.
What intervention does succeed? In my own work with families, I take a practical approach based on three principles:
1. It’s the parent who has to do most of the work, not the child.
2. Our first task is to find specific points where we can be helpful.
3. Our second task is to give children the chance to do it right.
Learning takes place when we do something right, not when others react to us for doing it wrong. It makes no sense to expect a child to have the inner resources to do all or most of the changing. We adults have more capacity to self-reflect and struggle with our habits than children do; we can reason with ourselves, foresee outcomes, engage our minds in the struggle with emotional habits. It’s unrealistic to expect our children to do this first, no matter how many stickers or stars we offer. And if we change, our children will follow.
What kind of change is necessary? First, we have to change our fundamental orientation: from an other-directed orientation (trying to alter the child’s behavior) to a self-directed orientation (taking responsibility for being a leader and model). We also have to change our language; examples of ways to re-frame language will be given in the case study. And we have to be alert for what needs to be changed in the context or environment to make it a better fit for the child. This means looking for specific things that tend to make our child become disorganized or over-aroused – being rushed or surprised, being told to stop before a task is complete, having to deal with too many people or choices at once, and so on. Then, what to do becomes clear: intervene at the specific point where the problem occurs.
As an analogy, it’s useful to remember when our children learned to walk. We focused our attention on removing potential obstacles to minimize tripping and falling; we tried to manage the environment so our child could practice getting it right and experience the feeling of success; and we cheered every incremental improvement, no matter how small. We didn’t punish child for not walking; we helped him to walk.
Rather than reacting to what our children do wrong, we need to give them more chances to do things right. Repetition is how people learn; biologically, it’s how neural pathways get laid down and reinforced. Whether adult or child, a person is least able to learn a new skill when he’s feeling confused, incompetent or negative. We learn best when we’re “catching on” or “getting the hang of it.”
A case study may best illustrate how to put these principles into practice.
Case study – Diana is an exceptionally bright seven year- old whose writing and math skills are several years beyond the level of her peers. Her idea of “fun” is to ask her mother to give her sheets of math problems to solve. She enjoys all intellectual challenges, especially those involving visual organization like finding patterns and solving puzzles. Blonde, blue-eyed, angelic looking – she seems the ideal child, and yet her mother Carol had come to me in tears. Diana’s idiosyncrasies and tantrums were turning their home life into a nightmare. The smallest thing that went wrong or “felt wrong” could cause an outburst of sobbing or rage. Despite their best effort, her parents were unable to predict, prevent or handle Diana’s frequent meltdowns, and Carol had come to feel utterly incompetent and defeated.
As we looked closely, however, and identified situations that tended to make Diana explode, we realized they had a common theme. When something offended Diana’s sense of how things were supposed to be, she was likely to fall apart. Whining and fretting would rapidly escalate to a full-scale tantrum that might include screaming, kicking and hitting. “I just can’t,” she would sob – whether it was get in the car, take off her jacket or come in to dinner. Her mother’s efforts to reason, cajole, encourage, soothe, threaten or offer suggestions were only irritating noise for her. Though obviously bright and talented, her rigid perfectionism was overpowering her strengths and spoiling everything.
I addressed the family’s situation in two ways:
1. Changing Carol’s point of view from how to make Diana behave better (make her different) to how to be helpful to her.
2. Empowering Diana – providing opportunities to figure out solutions in her own style and her own tempo.
We began from the recognition that Diana couldn’t bear it when things were not the way they were “supposed to be.” She had an exceptionally good memory and remembered everything literally, so half-truths and re-interpretations didn’t work to convince her that the revised version was really okay. The first step had to be to accept this fact and its importance to her – to acknowledge rather than deny her reality.
We often say to a child: “There’s no reason to cry, it’s just a tiny cut, it couldn’t possibly hurt that much!” or “Come on in, the water’s not cold at all!” But for the child the tiny cut does hurt and the warm water does feel cold. Are we teaching the child that he doesn’t or shouldn’t feel what he actually feels? Unintentionally, Carol had done this with her daughter: Many times she’d protested, “How can you get so upset over such a little thing?” Putting questions like this to a child doesn’t help: usually he doesn’t know the answer, or the answer he gives makes no sense to the parent. The first thing Carol needed to do, then, was to change her language.
I helped Carol re-train herself to say: “I can see that you …” or ”anyone would feel bad if … “ or “it really bothers you when … “ Often, just the recognition that she was understood was enough to reduce Diana’s hysteria to a level she could manage.
Especially effective was the formulation: “You’re the kind of person who… gets upset when you have to stop an activity … doesn’t like to be disappointed … has a hard time choosing between two things that sound good … “ and so on. The words “you’re the kind of person who … “ help a child know that he’s not the only one who’s ever felt this way and that this isn’t happening because he’s bad or flawed. The words also help to put borders around the problem so the child doesn’t feel globally defective.
Next, Carol worked on changing her initial response. She learned to look at a situation and ask herself, “ What would a helpful parent do?” instead of just reacting to what Diana was doing. This approach helped her predict, prepare and prevent a meltdown when she took Diana to a Broadway show.
She had gotten tickets to take Diana to a musical production of “Beauty and the Beast,” knowing how much her daughter loved the story yet dreading what would happen in this public place if the intensity became too much for her. Taking into account Diana’s specific issues, Carol came up with a simple and helpful plan: she brought fuzzy pink earmuffs and a frilly pink eye mask that Diana could put on whenever she wanted if the production became too intense. (They had a wonderful time.)
By taking a practical, non-judgmental approach, we helped Diana manage other stressful situations. For instance, Carol reported that Diana had been coming home each day intensely agitated about a boy in her class whose loud, intrusive and impulsive style was almost impossible for her to bear. Knowing that concretizing a situation can be helpful to a child, we came up with the idea of asking Diana to decorate a special box where she could put all her bad experiences. Whenever the boy upset her, she could write about it on an index card and put the card in the box “for storage.” Storing the impressions there, instead of in her mind, gave her a way to move on.
The benefits of this approach were threefold: (1) Diana felt heard and taken seriously, which calmed her and made her feel safe (a child who knows he is out of control does not feel safe); (2) she began to see her mother as helpful rather than punitive, uncaring or ineffectual, which improved their relationship; and (3) Carol began to see herself as a more competent parent, which helped her relax and respond more competently. I also gave Carol the exercise of writing about one moment each day when she felt like a good mother. This did not mean a moment when Diana was behaving well anyway, but a moment when Carol knew she’d responded the way a good mother would. By “changing her radar” to notice the positive moments, she began noticing them more and more – and even expecting to find them.
The next stage of our work involved teaching Diana to be helpful herself. Though Carol might suggest an intervention, it was Diana who had to carry it out. For instance, Diana had to ride along whenever Carol drove her brother Mark to his various activities (sports, band, scouts, etc.). This had become a daily battleground: Diana would flail wildly and shriek that she “couldn’t” get in and out of the car even one more time. At seven years old, leaving her home alone wasn’t a possibility, nor was not driving Mark where he needed to go, so we had to devise a solution.
Knowing that Diana took comfort in mathematical systems and patterns, I suggested having her keep a log of the exact amount of time she spent accompanying Mark to his activities. This meant telling time, subtracting to figure out the number of minutes and devising a system to record the information. We agreed that when she had “collected” sixty minutes of time, she could “trade them in” for an hour of something she wanted to do. Diana loved this! Not only did she appreciate the fairness of the arrangement but, because of the kind of person she was, she liked doing the calculations and creating a visually attractive recording system. Because it made use of her strengths, the activity was calming and empowering for her.
Finding ways to empower a child is the root of all effective interventions. In general, children have very little power in their lives. At school, where they spend most of their day, they are told when to move, when to eat, what kind of chair to occupy and near whom; they have no say in the lighting, noise level, duration, time of day or tempo of the tasks they must undertake. We take away all power except the power to say no, and if this is the only power a person has left, he will surely use it.
Empowerment means giving the child ways to say yes. For an inflexible child like Diana, this meant giving her more ways to yes – helping her extend the boundaries of her world. We began by working to “stretch the pictures” in her mind, since she tended to form very strong but narrow images that would trigger an unstoppable series of thoughts and emotions if reality didn’t match the image. For instance, she couldn’t bear when people broke their promises or things didn’t turn out as she expected. This came from a combination of high ideals, a strong moral sense and an inflexible temperament. Carol related an incident that illustrated how Diana’s mental rigidity led to a breakdown.
The family had decided to go to Carvel, a local ice cream store, but when they arrived they found it was closed. Diana became hysterical, inconsolable. Promising to go the next day or offering a substitute (buying ice cream at the supermarket, going to a different ice cream shop) were not acceptable alternatives for her because of her low adaptability.
To deal with this kind of situation, I taught Carol to include a back-up plan that was part of the plan. That is, she learned to say to Diana right at the beginning: “What’s our back-up plan if Carvel is closed?” In this way “going to Baskin Robbins” or “coming back tomorrow” or “getting donuts” was already part of the picture in her mind and therefore not perceived as a disappointment or unexpected change.
Another difficulty Diana encountered, in contrast, was when she became obsessed with too wide a range of possibilities rather than too narrow a range. Confronted with a choice, she could become so preoccupied with all the what-ifs, minor aspects, side-issues, possible choices and possible outcomes of those choices that she became unable to act. Carol recalled taking her to the toy store to spend a $20 birthday gift.
Diana became so worried about all the things she would not be choosing if she picked one thing and not another, and whether they might have been better than the thing she did pick, that she was unable to decide on anything at all. Carol, who had run out of time and patience and didn’t understand why her daughter was ruining what should have been a happy outing,, was on the verge of her own meltdown. Any suggestions she made about which item to choose, any prodding to hurry up, only made the situation worse because they didn’t address the source of the problem – which was that Diana could not process all these possibilities at once.
Here again, what was needed was to acknowledge and respect Diana’s reality. “You’re not ready to make a choice. That’s okay. You can think about it and let me know when you’re ready to come back and buy something.” Later, mother and daughter were faced with a similar situation, but this time Carol suggested that Diana make a list of the items she liked. Then she helped her organize all the factors she needed to consider—the prices of the various toys, their sizes, how many different things she could do with each of them, whether her friends had similar toys, and so on. They chose the items that Diana especially liked and organized all the information in a grid, the kind of activity Diana enjoyed and found comforting. This gave her concrete way to organize the material in her mind until she was ready to make her selection. Carol also allowed her to take as much time as she needed to process the situation. Tempo, and the mismatch between a child’s tempo and the tempo of those around him, can be a key factor in cognitive or emotional breakdowns. A child who is told to proceed more quickly or more slowly than his internal rhythm dictates will protest in the only way available – by saying no.
For Diana, as for any child, effective strategies made use of her strengths – her love of organization, her mathematical ability, her strong visual creativity. Good solutions don’t come from suppressing a person’s weaknesses but from engaging his strengths. The eventual goal is to help Diana devise solutions for herself. At seven, her parents still need to be the main helpers but more and more as a child grows, he should be encouraged to figure things out for himself, based on his understanding of the kind of person he is.
As the parent of gifted but challenging child, look to these basic principles to help your child learn to manage stressful situations:
1. Be helpful. You can ask your child: “What do you need right now?” (But you have to be ready to take his answer seriously.)
2. Focus on modifying the context, not on “fixing” the child.
3. Give your child a chance to re-play the scene and learn from the experience of getting it right.
4. Give your child time and space to process the situation in his own way.
Remember that growth and development come from nourishing a person’s strengths, not from “controlling” or ”repairing” his weaknesses. Throw out those sticker charts and enjoy your unique child!
________________________________________________________
Barbara Probst, CSW, LMSW, is a clinical social worker specializing in helping families whose “different” children have somehow become “difficult” children – often because their sensitivity, intensity, or giftedness is mistaken for a “disorder.” In addition to running parent support groups and working with individuals and families, she also teaches at Fordham University’s Graduate School of Social Service, gives presentations throughout Westchester Country, New York, and is the mother of two adolescents.