We had our monthly session with our Occupational Therapist today. Maddy was assessed by a Physiotherapist for her gross motor skills with positive results! Hoorah!
We did some troubleshooting on some of the recent issues we’re having at home, like transition from daycare to home. Our OT explained that it’s the let-down-meltdown we’re likely experiencing. Basically, kiddos try so hard to keep it together all day at daycare/school, and once they’re home in a “safe” environment, they let it all out. We came up with some plans to try to make this part of the day easier and more enjoyable for all of us. To aid in the transition from daycare to home we are going to:
1) Use a “transition object”. This will be something I give to Maddy when I pick her up from daycare – and that’s the only time she will get it. It will eventually be a signal to her that we’re getting in the car and going home. We have no idea what kind of object we’re going to get – any suggestions welcome!
2) Once we arrive at home, we will sit in a room with the lights low, with some soft music playing, and I will do some proprioceptive techniques, like joint compression. Our OT warned us that Maddy will likely fight this for a week or so, but to keep at it. At her age, she knows she needs something, but doesn’t know what, and so she’ll fight it until she is able to figure out that it makes her feel better.
3) We also will be starting to use a timer clock to allow Maddy to “see” when things are coming, like dinner.
4) Our OT also suggested we start using a transition board – and thankfully, my sister, Lindsay (the speech-language pathologist), is in the process of making us one. This will help Maddy to understand and prepare for her daily schedule.
5) Finally, our OT is going to do a daycare visit to assess if there is anything else they can help us with (for example, like giving a verbal warning about when mom comes to pick her up in the day), and to troubleshoot some of their issues.
Fingers crossed that we have some success with these techniques.
Another new thing we will be trying is behavioural therapy. Maddy had a very tough day today, and our OT got to witness a lot of what I see at home in the evenings. That, in combination with describing some of Maddy’s issues, our OT indicated that she believed Maddy is showing some anxiety and control issues (particularly severe separation anxiety). Eric and I aren’t clear on whether or not her anxiety is significant and would need to be treated if she didn’t have other challenges, or if it’s significant because of her other known challenges – but, really, that doesn’t matter at this point. In any case, behavioural therapy was exactly what I was hoping to hear in going into today’s session, even before I suspected Maddy was suffering from anxiety.
Very briefly, some of Maddy’s signs of anxiety are:
- A very new fear of going to bed – she will cling to your neck, kick her legs, scream, and shake her head no when we try to put her down to sleep. If we actually put her down when she’s like this, she will scream, and scream, and scream. Her voice has become raw because of all of her screaming.
- She wakes on average three times a night in complete and utter panic – and she is awake. There is no getting her back to sleep if it’s 4am or later. If she wakes then, she’s up for the day. We are wondering if it’s possible she’s having nightmares, though, of course, this is impossible to know. She actually has a goose egg on her head from one of last night’s wakings – she smashed her head off of the side of her crib in the 30 seconds it took us to get to her room. She continues to flail and smash her body around on the floor of our room for a good half hour or so before she’s calm enough to accept being held.
- She is refusing to nap, unless we’re driving in the car or she’s sleeping in bed with me (which, is kinda impossible when I’m at work).
- When we’re out in public, if a stranger looks at her, she bursts into tears and wants to be held by me. Once this happens, she will scream if she’s in her stroller. I now just carry her home and push the stroller with my other arm.
- She is not interested in eating at all. In particular, she is terrified again to be in her chair. She will ask for food and sit in her chair for 10 seconds before she starts reaching for me and screaming.
- If I am around, she very rarely will let others hold her.
- It often takes her an hour or more to warm up to people before she’ll leave my side. Often even after this time, she will cry if they get too close.
- At daycare, she becomes very attached to a worker. When the worker goes on break, she has a meltdown for about a half hour. The cycle repeats the entire day as she attaches herself to various women.
- Every Monday it takes half a day for her to warm up to her daycare workers – her worker indicated this as not typical for the length of time she’s been there.
You might be thinking that Maddy is 15 months and that is around the age separation anxiety peaks – and you’re right. You’d also be right to think that often toddler anxiety seems extreme. Anxiety in toddlers becomes a concern when it significantly impacts their life – disrupting sleep patterns, affecting interactions with family and friends, or impacting daily life in the home. In Maddy’s case, we suspect that the anxiety is impacting her eating, sleeping, play, and interactions with others.
Behaviour issues arise from this anxiety as she tries to control what she can – particularly since she has little control over her sensory challenges. Not giving her the control she wants (or needs in order to feel safe), like taking away food she shouldn’t eat, for example, triggers major meltdowns. Eric and I contribute to this in many ways too. We give in to a lot of things we probably shouldn’t, because with lack of sleep comes lack of energy, and we just don’t have the energy to deal with all of the behaviour issues. This is where behavioural therapy should help us.
Why does Maddy have anxiety? I wish I could tell you. It might just be part of her temperament, but more likely, a history of GI and sensory issues has contributed to this. Another piece of the complex tapestry.
I had a hard day today post-therapy. On the one hand, I’m so happy that we’re seeing a behavioural therapist to help us all adjust better. It really is exactly what I wanted to hear. On the other hand, I feel horrible, awful, weepy, and guilty. Despite being able to intellectually understand that I did not create Maddy’s anxiety, I still feel guilty. Deep down there is still a part of me that feels as though I’ve let Maddy down – that I’ve failed at helping her navigate through the first 15 months of her life. Never in a million years did I think that my 15 month old child would experience enough anxiety that we would need to see a behavioural therapist to sort it out. I can’t even imagine what it must be like to live inside Maddy’s body for a day – and to not have any understanding of why. I mean, I barely can wrap my head around why, despite the hours I’ve spent reading about her issues and talking to therapists.
At the end of the day today I went to pick Maddy up at daycare, and for the first time they talked to me about the struggles they’re having with her – eating, sleeping, being clingy/not playing. Huh. Everything we’re struggling with at home. Her primary worker told me that listening to her cry in her crib just broke her heart. I knew exactly what she was talking about: the urgent shrieking that lets you know there is no chance Maddy will calm down. It also lets you know that you will no longer be able to help her calm down. They also expressed concern over the lack of sleep Maddy is getting – on average a total of 7 hours the last few days (including naps). She’s 15 months and she has bags under her eyes. She is obviously exhausted, and yet cannot sleep. We brainstormed together, but ultimately, none of us can force her to sleep. I absolutely adore these women, and they take so much care with Maddy. Their compassion was written all over their faces.
After leaving daycare, we went to the post office to pick up a package. While waiting in line, an elderly man leaned over to say hi to Maddy. She promptly scrunched up her nose and smacked him right in the face. It was the cherry on top of my oh-so-crummy day. I sheepishly apologized and got out of there as quickly as I could manage.
Like always, I am feeling everything at once: hope, fear, and sadness. But, mostly I’m feeling anxious over my baby’s anxiety. How’s that for full circle?
The day ended on a high note with my first pole dancing lessons (so much fun!), and a surprise candle lit dinner (gotta love my oh-so-sweet hubby). Another day done – keeping my chin up and forging into tomorrow.