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Part 4: Keeping Your Child Healthy  >  Psychological Concerns

PART 4: KEEPING YOUR CHILD HEALTHY

PSYCHOLOGICAL CONCERNS
Your child will go through different stages in life that may cause you concern because of the things she says or does or does not do. Most of these manifestations are just a part of growing up and require you to do nothing but handle the situation calmly. 

In many areas, a concept of readiness applies. The child will not do something or not move on to another stage of behavioural development till she is ready for it. This applies especially to toilet training (discussed hereafter) and agerelated masturbatory tendencies, stealing and swearing. In all such behaviours, the main management technique is to distract the child and not to draw her attention to them.


DAYDREAMING
To a certain extent, daydreaming is normal. There is need for concern only when it becomes so frequent that it starts interfering with your child’s normal activities; especially if she stops taking interest in her studies, stops interacting with others, becomes withdrawn and seems to live in her own world of fantasy and dreams.

A child who is dull may daydream because she cannot cope with her studies. On the other hand, a child with superior intelligence may daydream because she finds her lessons too simple. 

A child who has problems because of the wrong attitudes of parents and siblings may daydream. She may have fantasies of revenge, although she may also feel guilty for such uncharitable thoughts towards her near and dear ones. A child who has too much free time may also daydream. Keep her occupied with activities that interest her. Talk to your doctor if you feel daydreaming is becoming a problem with your child.


LYING

When your 3-year-old tells you with mischief in her eyes that she is not at home, she is not lying; she is playing a game with you. Similarly, a preschool child may make up tall stories to amuse herself or to amuse you. Do not take this seriously. However, you can’t afford to ignore the situation if she tries to deceive you by being untruthful.

Still, don’t be in a big hurry to punish her. First, try and find out why she would want to tell a lie. When she broke the glass last time and owned up, did you praise her for speaking the truth and tell her to be careful in future, or did you beat her up for her carelessness? If she was punished for being truthful, she may have decided not to admit her mistake and instead tell a lie.

Trouble at school or at home may also cause a child to take recourse to lying. Young teenagers may leave home to go to school or college and instead land up elsewhere. When confronted, they may lie.

Parents who are not honest themselves can hardly expect truthfulness from their children.

Children must get the message that we all make mistakes and should not hesitate to own up to them. Teach your children to learn from their mistakes and then move forward; they should never be so afraid of the consequences that they need to lie.


TOILET TRAINING
Do not force an unwilling child below the age of 2 to sit on a potty or a toilet seat, but attempt the process of toilet training in a gentle way at an early age.

Most babies will pass a motion or will pee after getting up from sleep or after a feed. Take advantage of this knowledge. Take the child near the toilet. Hold him over it. Make a hissing noise. Wait only for a short while. He may oblige you by passing urine with or without stools. If he does, you have saved a nappy and reduced the risk of your child getting a nappy skin rash. If he does not, let it go.

Some babies who respond may do so because of a ‘conditioned reflex’. In our rural areas (and also in some urban homes), I have seen the mother (or the grandmother) sit down on the floor with her legs straightened in front of her. She makes the small baby sit between her two legs nearer her ankles. The baby faces her, and her upright feet support the baby’s back. The baby often passes urine and/or a motion on newspaper in this position.

When the child is able to sit independently, buy a brightcoloured potty that sits on the floor. Place it near a wall, and put the child gently on it as soon as she wakes up or after she has had her feed. Sit near her or have your maid sit near her. Give her a kiss if she passes urine or a motion. Do not look annoyed if she doesn’t.

As she starts walking around, you will be able to make out when she is ready to pass stools or urine. She may suddenly stop running. Her facial expressions may change. She may point towards her genitals. Take a cue from her signals. Quietly remove her diaper and help her sit on her potty. Do not force her if she does not want to. If she wets her clothes before you can march her towards the potty, do not scold her. Give her a kiss when she does oblige by passing the motion or urine in her potty.

Your son may show interest in passing urine while standing up as he grows, usually after he observes an older sibling doing it. Your husband may also show him how. (However, psychologists opine that it is not advisable for parents to keep exhibiting their genitals before their children. If the child sees them by accident, do not give the incident undue importance.) He may now want to sit on an adult toilet seat. Put a small training seat on it; this is easily available in the market. Do not flush the toilet while he is sitting on the seat. Some children get scared at this; they fear that they may get sucked into the toilet.

Most children use the potty and later the toilet seat properly between 2 and 3 years of age.

I have also noticed that a child who is encouraged to pass urine just before bedtime at night and again as soon as he gets up in the morning may have a dry night as early as the age of one year. However, we must remember that some children will wet their bed normally even at an older age, as discussed under Bed-wetting in THE A - Z CHILDHOOD ILLNESSES.


MASTURBATION
Masturbation is a normal phase in most children’s lives. It is not a behaviour problem unless parents make it so by mismanagement. In fact, according to Dr. Mahinder Watsa, consultant in sexual medicine, masturbation as a means of relieving sexual tension is a better substitute for sexual intercourse before marriage than indiscriminate sexual encounters.

Age Incidence
Though more common during the adolescent period, masturbation or self-stimulation of the genitals is practised at all ages — even in infancy and among both male and female children. Most children stop masturbating after a year or so. It may be noticed more frequently to begin with, then becomes less frequent and finally stops.

Masturbation must be differentiated from just touching the sex organs or handling them. This is a phase through which almost every child passes. Do not shout at her for this. At the most, you may distract the child by giving her something else to handle.

In a typical case, masturbation begins with rhythmic movements of the hip while the child is lying on her back or stomach. Later, she rubs her thighs together, keeps rubbing them, her face becomes flushed, and she appears to be lost in her world, looking constantly in one direction and finally sweats (as if she has had an orgasm) before the whole act ends. If the habit continues for some time, she may press against any piece of furniture and repeat the act.

CAUSE: I have not found any obvious cause. All the children’s parents have been very caring, though some confessed that they might have made the child conscious of the act, which might have made matters worse. However, rule out any local irritation and feelings of insecurity in the child. Your doctor will try to rule out conditions like diaper rash, fungal infection of the genital area, eczema and itching due to threadworms.

MANAGEMENT: Nothing need be done with smaller children. It is likely to stop on its own. Be extra careful with adolescents. First of all, the parents must understand that most often, masturbation is a normal passing phase. Masturbation does not mean that the child has become a pervert, that he/she will become weak, or has fallen into bad company. The only thing that parents can do is to make sure that the child does not become guilt-ridden or obsessed with the subject. 

The child must receive sex education from the parents or from another appropriate source. The teenager must be encouraged to take part in sports and other outdoor activities. At an opportune time, you may discuss the purpose of living without ever making your young friend feel ashamed for taking recourse to masturbation.

However, if you feel ill at ease with the situation, do discuss the subject with a counsellor. The counsellor may find that the child is passing through a stressful phase in his/her life. The child may have been sexually abused.

Take note however if the masturbation is excessive or if the child also does it in public.


STEALING

A toddler does not understand the difference between her own property and someone else’s. But as she enters the preschool age, the concept of ‘not taking what belongs to others’ should be gently but firmly built into her evolving personality. By the time the child enters school, it should be made absolutely clear to her that we have no right on the property of others. Anything belonging to others must be returned. If parents or teachers ignore minor offences, the habit may continue and may land the child in serious trouble later in life. Therefore, a toddler’s act of possessiveness can be ignored, but the older child’s attempt at stealing must be nipped in the bud.

Disturbed family life, problems at school, poor parental example, bad company, ‘not enough’ pocket money and strict parents or teachers, are all cited as possible causes responsible for stealing. 

A child is not likely to fall into the habit of stealing if you meet her emotional needs. Discipline her in an atmosphere of love and trust.

Professional help must be sought if the habit seems to be becoming frequent.


SWEARING
Small children pick up words like ‘hell’, ‘shit’, ‘bullshit’, ‘sala’, ‘idiot’, etc. from adults without even knowing their meanings. Foul language or dirty words can also be learnt from friends. Minor swearing is not uncommon among school children. Do not be too concerned as long as the child does not swear at others.

Parents who do not swear, even if upset, have a right to tell their youngster to stop it. If your son or daughter still swears, deal with him or her firmly. (See the section on Discipline in the chapter on MEETING THE EMOTIONAL NEEDS OF CHILDREN.) Some parents will tolerate their son using dirty words, but not their daughter. They may even say, ‘Girls are not supposed to use such language!’ This is not the right approach. Both boys and girls need to be handled in a similar manner.

Some parents become furious on hearing dirty words. They may hit the child in anger or may use even more foul language. Such an impulsive reaction could have the opposite effect on the child’s behaviour and should be avoided at all costs.

Ignoring a toddler who uses a dirty word, and firm handling of your older child is all that is required in most cases.


HOMOSEXUALITY
Parents’ fears that their adolescent may be ‘gay’ are usually unfounded. Their suspicions are usually aroused by their children cross-dressing (when a son dresses like a girl, or a daughter like a boy) or if they behave like the opposite sex. It is the stereotypical roles assigned to the two sexes that lead to such false notions. Our society has set norms that suggest that a boy cannot shed tears and that a girl cannot climb a tree. This has to change.

Most of us have a masculine side as well as a feminine side to our personality. We must cherish both these aspects. Why can’t a man be tender and a woman strong and yet tender?

Conditioned by societal stereotypes, a teenager may wrongly believe himself to be homosexual because he finds another boy, or a male teacher, or an actor, or a sportsman attractive. Some teenagers who think that they are homosexuals or lesbians may disclose their sexual orientation in their late teens; others may never reveal it. 

Parents who are faced with a youngster who is not sure of his or her sexual identity must sit down with the child and explain that it is quite normal to appreciate the good qualities in a person of the same sex and feel attracted towards them and that it could be a passing phase.


No Easy Answers

Here are a few suggestions on handling the situation if your son reveals that he is homosexual or your daughter informs you that she is a lesbian.

  • Do not reject your youngster. Continue to love and support him or her. Treat him or her as you would a heterosexual youngster.
  • Share with him or her your anxieties about his or her adjustment to the society in which he or she has to live, or the increased risk of AIDS and other sexually transmitted diseases among homosexuals. The risk is more because if a homosexual practises anal intercourse instead of vaginal intercourse, the mucus lining of the rectum is more likely to be damaged than that of the vagina.
  • If you strongly feel that homosexuality is unnatural, tell them so. But respect the decision they have taken to acknowledge a different sexual orientation, and do not treat it as a purely psychological concern.
  • Consult a counsellor if you and the child find it difficult to handle the situation.


SUICIDE
Cases of suicide among teenagers are on the rise.

Do not take it lightly if a teenager attempts suicide or talks about it. Even young school children may seem suicidal. Although these may simply be attempts to get more attention from you, take these calls for help seriously. 

Sit down and talk to your child. Ask her if she is passing through a rough time. Is she unduly depressed, hurt, upset, angry? Does she feel hopeless or uncared for? Has she failed in a test, lost a friend or a close relative? Is she disturbed about fights at home? Has she done something she feels guilty about? Spend more time with a child who seems withdrawn or depressed.


After A Suicide Attempt

If your son or daughter has attempted suicide, you must get professional help immediately. Talk to your paediatrician who may refer the child to a psychiatrist or a psychologist-cumfamily therapist. Do not be ashamed about visiting a psychiatrist or psychologist. It is important to visit these professionals before things get out of hand. However, take these steps under the guidance of your paediatrician or family physician. 

Some schools also have expert counsellors who can be depended upon. These experts will help build your youngster’s self-esteem. Counselling of parents and the child is all that is needed in most cases. Youngsters with serious psychiatric problems may, however, also need some medication. 




7 March, 2016

 
Part 4
Keeping Your Child Healthy
Choosing A Paediatrician
Proper Use of Medicines
Home Remedies
A First Aid Kit
The A-Z of Childhood Illnesses
Psychological Concerns
Managing A Hospital Stay
Emergencies
Prayer And Your Child's Health
The Role of Nature Cure
Homoeopathy
Ayurveda and Child Care
Congenital Heart Disease FAQ
 
Guide to Child Care
Home
Introduction
1 Pregnancy, Childbirth ...
2 The Growing Years
3 Feeding Infants, ...
4 Keeping Your Child Healthy
5 Keeping Your Child Happy
About Dr. R. K. Anand
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