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Can’t tell a behavioural from a medical issue? Consult an expert

Can’t tell a behavioural from a medical issue? Consult an expert
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First Published: Fri, Feb 18 2011. 09 02 PM IST

Attention deficiency: You can get the child to write down all his questions and tell him that you’ll take them up later. Thinkstock
Attention deficiency: You can get the child to write down all his questions and tell him that you’ll take them up later. Thinkstock
Updated: Fri, Feb 18 2011. 09 02 PM IST
Our son was operated on soon after his birth for Hirschsprung’s disease. Due to the disease, part of his colon was without sensation and he was not able to pass motions. A timely operation cured him. However, we had to make an extra effort to toilet-train him. Now he is 8. However, he still has the habit of passing motions early morning while asleep in bed. We have tried explanations and even fear tactics to make him get over this, but he is unable to do so. He understands that what he is doing is wrong, but finds himself helpless. How should we handle this?
Whether your child is completely and genuinely unable to control his bowels, or whether it is now only a delayed toilet-training issue, is a difficult call for you to take. You will have to seek medical advice and go in for face-to-face counselling (by his doctor if it’s possible, or with an allied counsellor in your city). Perhaps your doctor will advise surgical procedures such as a stoma; however, it is not my place to advise you on the specific medical solutions and strategies you would need to explore.
Attention deficiency: You can get the child to write down all his questions and tell him that you’ll take them up later. Thinkstock
For all parents dealing with children with congenital conditions and disorders of this kind, there is a need to constantly weigh between making allowances for the child’s condition, and insisting on behavioural protocols in line with all other “normal” children. Many parents in your situation talk about how exhausting and demanding this aspect of the situation is.
Both the child and parents have, since birth, had to deal with doctors, hospitals, medication, surgical procedures, critical care and aftercare, difficult decisions, financial issues. There are also the many social repercussions of the child’s condition. In this case, that an eight-year-old is not able to indicate that he needs to move his bowels also becomes a socially awkward situation when it comes to going on vacation, staying in other people’s homes, having house guests, etc. Toilet training can in itself be a frustrating part of parenting—and more so in your case.
All this takes a toll on the family’s psychological well-being, and stress is bound to build up in both, the parents as well as the child (and any other children, grandparents, etc., in the family). Such families must seek counselling as well as support groups, either in your own town/city or on the Internet. A good family doctor as well as your child’s specialist consultant may be the best people to help you find other parents in the same or similar situations. Talking to them is likely to help you come up with coping strategies and concrete solutions, as well as plan for the future. Equally, parents of children with conditions that need close monitoring and handling need to focus on their own physical health, as the demand on your mind, body and energies is more than on other parents.
I would suggest you look for ongoing medical, emotional/psychological and social support in whatever form you can tap into, both for yourself and your son.
My son is in class VI, and until now has had an excellent rapport with all his teachers. However, one of his science teachers recently called to tell us something we had not noticed before—he raises a question but then refuses to listen to any of the explanations given, gives some counterpoint and then continues arguing, wasting time and distracting the entire class. I have tried to speak to him about this, but he simply won’t accept he is doing something odd. I find him doing the same thing while we work on his science homework together. Please suggest what we can do.
Sometimes behaviour of this kind could be a bid to get attention. Or it could be that he has a genuinely different or lateral way of thinking, is very quick, and that’s why he has all the questions. Third, there could be an attention deficiency issue at work, and perhaps you could get him tested for this. You could gently but firmly tell him that the next time he does this (and you could suggest his teacher take the same stand) you will discuss the byways and implications later, but that you need to stick to the work at hand. In class, his teacher too could say that since the others seem to have understood the concept, the class needs to move on, but that she will address his questions later. Both you and the teacher can get him to write down all those questions that crowd his mind and threaten to hijack the study session. Tell him to list them, and you’ll take them up later. Do assure him that you will discuss it later with him.
If when you do, you or the teacher get the feeling that he’s simply arguing to increase the interaction with you (getting attention), then do take a close look at why he is feeling ignored, and whether only “studies” is an area in which he feels you will pay attention to him. Find other things to do with your son.
Also, if you feel it’s more about an active mind needing more “fodder”, set him a slightly different task—if it is a humanities subject that you’re teaching (or even a science one, for that matter), ask him to write an essay or a debate speech for you, putting forth his point. You could have him join the debating team if his school has one, to channelize his need to analyse, argue, talk. This will also teach him that it’s a two-way process—that he needs to learn to put forth things in a way that people will listen, and needs also to listen to what the other person says in response. The exercise in debating also helps because you can set a time limit for something and he has to concretely come up with an argument or an idea within that time.
There is one thing that some children cleverly indulge in—which is to argue so that they can duck actually doing something. What better way to avoid doing mundane school or house work than to debate it endlessly! Watch out for that and see if this factor is at work too.
Gouri Dange is the author of ABCs of Parenting.Write to Gouri at learningcurve@livemint.com
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First Published: Fri, Feb 18 2011. 09 02 PM IST