SleepTalk™ for Children

Toileting, Anxiety, Sibling Rivalry Issues

Presenting Situation.
“Jan 5th 2011 – ‘N’ is an 8 year old girl presenting with bedwetting and faecal enuresis. Her parents have tried “everything” in the past and she has been undergoing counselling in the past year.  Though a very bright child, N’s parents report extreme anxiety and difficult behaviours, notably a troubled relationship with her 10 year old sister.”

Foundation process
“N saw enormous changes in a very short time frame, on commencing SleepTalk™. Though in the past she had been afraid to go anywhere on her own and would struggle to deal with anger and anxiety – mostly resulting in “melt downs”, within the first three weeks, ‘N’ had showed a significant turnaround.

N’s parents reported a number of changes after three weeks.
More able to talk through concerns calmly without melt downs.
Walked to the shops and scouts on her own.
Asked to go to school camp.
Had the first dry nights of her life.
Stopped hiding (and lying about) soiled pants and stopped soiling.
Happy to talk on the phone to people.

Parents report enormous positive feedback! And these are just some of the main examples. Even with such positive changes and feedback, ‘N’s parents expressed there was still some way to go with N’s ability to deal with anger, with her self-esteem and they expressed significant concern over N’s continued troubled relationship with her elder sister.

We chose to keep the ‘Foundation’ statements for some weeks longer and added in the sibling support statement, suspecting that the sibling relationship is potentially the prime area of pain and anxiety for ‘N’.”

Follow up
“On contacting ‘N’s parents three weeks later, I was informed that almost instantly after adding in the sibling support statement, ‘N’ regressed. She began (and continued to) soiling and bedwetting again and was less cooperative.  We chose to continue but not change the statements whilst ‘N’ was unsettled – and two weeks later the parents reported seeing slow improvement. She is very cognitive about the issue now too – shows a real willingness to beat the issue and a desire to be clean. She is well on her way to conquering her toileting troubles!”

Conclusion
“This continues to be a very interesting case to work with. ‘N’ had an extreme abreaction to the addition of a sibling support statement. This fits with the parent’s information given about the troubled sibling relationship and appears to be a deep source of anxiety and stress for ’N’. It seems that, upon adding that her sister loves her, her brain was not able to neither compute this nor take it on as truth easily. A month on and she is showing marked improvement but still has some way to go. Her parents remarked: “Thank God for SleepTalk™!” and are very grateful for the obvious effect it has had in their lives. I am grateful for their willingness to stick to the program with patience, noting that it is not a quick fix for their daughter but is slowly working love through the deepest parts of her doubts and fears. What a wonderful thing to watch.”

Up Date: 20 April 2011
“The mum just emailed me to let me know that it has finally turned a corner! Toileting issues have been under total control for a week now (and most of last week) and she is a “happy little girl”. Mostly holidays are bad for her – I guess, having her sister around with her full time – but they have been coasting through that alright too.  Great news to hear…just thought I’d let you know!”

SW – Consultant.

Asperger’s Syndrome / Anxiety / Nightmares

Session 1

Presenting Issue
“J” is a very anxious child who has a fear of being left behind by his parents. He is also experiencing night tremors, stuttering, nail biting, lack of confidence and is melodramatic and “sooky”.

Detailed Case History
“J” was lost at a carnival a year before and since then does not let his parents out of his sight. If his parents need to go somewhere without him he has an anxiety attack (trouble breathing and panicking).

His parents need to sit with him and explain they will come back each and every day before going to work, before dropping him off at school or to other family members if they need to go out. Even when his parents are in the next room and “J” cannot see them he continually calls out for reassurance that they are still nearby.

This is all becoming a big burden to “J”’s parents but their main concern is school. One of them has to stay at school, stay through assembly and wait around until “J” goes into class. “J” is also very sensitive and is not integrating with others in his class.
“J”’s parents are also concern with his melodramatics e.g. if he knocks his leg then all hell breaks loose even if there is no damage/cut/blood etc.

Process/Discussion
I explained the SleepTalk Process to “S” and “J”, answered any questions/concerns and then we proceeded to complete “Where Does My Child Stand Now?” (see attached).
The major areas highlighted as Very Poor/Poor in this process were:

  • Reading Skills
  • Nail Biting
  • Ability to Remain Calm
  • Ability to Cope Without Parents

“S” and “J” both committed to the SleepTalk Process and couldn’t wait to get home and start.

 

Session 2

Feedback
“S” and “J” were amazed at the change in “J” over a four week period. As we went through “Where Does My Child Stand Now” there were significant improvements in specific areas up to 80%.

“J” had a couple of evenings where he didn’t complete the script, as one evening “J” sat bolt upright in bed and “J” thought he was awake so he just said “I love you” and left the room. Another evening “J” just said “I know, I know” so “J” again said “I love you” and left the room.
Both “S” and “J” have been diligent about working with “J” every night. In four weeks they only missed two evenings.

  • Not experiencing any night tremors
  • School has been fun – he now “loves his friends”
  • No more waiting in assembly line.
  • Happy to say goodbye each morning to go to school.
  • Hasn’t been asking (over the last two weeks), “where are you?”
  • No longer biting his nails – “S” had to actually cut them
  • Is spending longer periods of time alone playing.
  • Has come out of his shell at school and more a leader than a follower.
  • Cut his finger a week ago and did not whine, was not as dramatic and managed to stay calm.
  • Had to leave “J” with his cousin for a day and they were going to go swimming. This would normally be a nightmare but once “S” told him and asked if he would be OK, he said “I’m a bit nervous but I will be OK”

Primary Area of Need
The family is moving to a country town in a month and “J” needs to start a new school. “S” and “J” have discussed this with him and he seems OK but they would like to continue with SleepTalk to ensure that he copes well with this move and fits into his new school with the minimum of anxiety.

Specific Suggestions Given
We all worked together to formulate the following suggestion:
You’re safe, you belong and it’s OK to be you.

 

Session 3

Feedback
This session was completed by phone:
The move has gone well for “J”. He had a reoccurrence of night tremors in the first week but has not had any further occurrences. He has assimilated fantastically at his new school and has made a lot of new friends.

“J” is also enjoying the rural life and loves playing with the farm animals and not worrying about where his parents are at all times.

End Result
“S” and “J” said they will keep using SleepTalk, alternating between the foundation process and their primary suggestion.

Tantrums / Bullying / Sibling Rivalry / Speech / Anxiety / Pooing Issues / Refusing Food

B was almost 3 at the time that her Mum commenced Sleeptalk ™ with her. B has a new baby sister, E two months old. Mum says that B is a confident, interested and energetic child. B is a “strong-willed” child, who likes to do “her own thing”. However, B doesn’t always listen to or follow Mum’s directions, or cooperate with Mum, eg holding hands when in the carpark for safety, which concerned Mum. To get Mum’s attention, B often pushes other children at crèche, pokes her sister or pulls on her arm (daily) or will cry. Mum noted a there was a bit of sibling rivalry going on. B will hit her head on the floor or walls at times, throwing tantrums. When things don’t go right or when she wants her own way, Mum says that B overacts.

B speech had been assessed and found to be 6 months behind her age appropriate development (ie limited vocabulary, enunciation concerns, not speaking clearly enough to be understood, etc). As a result she visits a Speech Therapist regularly. B responds well to routine, eg bed-time which has a pre-warning beforehand and a bed-time story which works well Mum says. Although B sleeps through the night, she usually takes sometime to settle initially. B reacts strongly towards specific things and will cry straight away. For instance, at the sight of the vacuum cleaner she will immediately start crying and run to her room or when shown Tigger (the toy tiger) which when wound up will bounce and jump around. B likes and wants order Mum says, eg the doll has to have her hat off. Although previously toilet trained, B had fissures now, so was reluctant to do ‘poos’ (often holding on for some days before going), or go to the toilet to do ‘poos’ due to the pain involved. While Mum has sought medical advice and treatment, she says that B goes and puts on a ‘pull-up’ herself to do ‘poos’ in, rather than going in the toilet.
While Mum said that she would commit to this process, she nevertheless said on parting that “We’ll see if it works”, which l found interesting.

SleepTalk ™ Foundation Process commenced.
Spoke with Mum a couple of days after our first meeting and she said that she felt confident giving the SleepTalk ™ process. Sent sms after two weeks; all going well Mum reported.

Four weeks into the SleepTalk ™ process, spoke with Mum on the phone to arrange our next meeting. Mum said that she had been able to do SleepTalk ™ each night, only missing a couple of nights. Mum said that B was more calm and cooperative now, even stopping, looking and listening to Mum at times which didn’t happen before. B had even begun to hold Mum’s hand in the carpark, which Mum was very pleased about.

Second meeting with Mum
A number of substantial improvements in B’s development and behaviour were recognised and noted during this meeting; most with an increase of 10-15%. In reflection and comparison, Mum was able to identify that B had become calmer, more cooperative and focused, and her speech had improved. This was also noted by the Speech Therapist, two weeks earlier (who is interested in finding out more about SleepTalk ™). Mum said that now B was more focused in her play and activities, instead of having ‘excess’ energy as previously, eg not swinging from the curtains as much. B was now more placid, more affectionate, giving more cuddles, especially in the mornings. B was more sharing and caring of her baby sister, saying ‘gentle’ when touching the baby which was welcomed by Mum. Her speech had improved greatly, with B saying new words, more sentences, making more sense in her communication, reciting songs and speaking more clearly. Whereas previously B refused to even try any new foods at all, she was now more willing to even put these foods to her lips and taste them. Increased interest in sharing books with her Mum and letting her Mum read to her and talking with her about books through the day had occurred.

B was playing, sharing and dealing with other kids at crèche better, with less aggression – not snatching toys from them or hitting them as much. B was communication with other children had improved and was verbalizing more. Her concentration on one activity was lasting a lot longer, being more attentive and focused. While her imagination and creativity had become greater, making up games with play dough, wearing objects as ‘crowns’, making up songs.

B’s behaviour at home and in public had become less demonstrative, by compiling with and following Mum’s directions more (eg holding hands in the carpark, packing up toys when asked), with the head banging/throwing tantrums occurring only occasionally. Mum believed as she had put more boundaries in place and B was listening more, she could reason with B and explain consequences to her. Because of this, B was following through more positively rather than reacting negatively by screaming, throwing tantrums, etc. B was not being sent to her room as much for time out. Rather than becoming frustrated quickly with things, B had become calmer with everyday activities, such as tying shoe laces, or when a puzzle piece was missing or didn’t fit.

Mum believed that B’s level of anxiety had reduced (eg trying to eat more things, more willing to do things, calmer, etc); she could even touch the vacuum cleaner now after it was turned off. However she still reacted by yelling “NO” when Tigger appeared. Greater self-help skills by B were recognised by Mum, with B washing her hands after toileting and when appropriate, packing up toys and putting away, cooperating more with less resistance and fighting. While B still wanted to wear pull-ups for ‘poos’, she had started to go to the toilet by herself without being taken by her Mum. Although Dad is not taking part in the nightly SleepTalk ™ process, he can see a difference in B’s behaviour Mum said.

Choosing the Primary Area of Need

In determining B’s Primary Area of Need, two priorities were selected by Mum: toileting and speech. Mum is very concerned and anxious, wanting to do all she can to help with B’s speech development, which had improved the Speech Therapist had told her. However, of the two areas, Mum wanted B to be able to go to the toilet to do ‘poos’, without holding on or thinking that it would still be painful. Mum felt that her daughter was becoming constipated regularly because of this which also worried Mum. A specific statement “You can do ‘poos’ in the toilet easily – its OK”, was agreed upon and a follow up appointment made for 6 weeks’ time.

 
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