Ella's Meltdowns

I will have a section where I track my oldest daughter's meltdowns... primarily for my own need to keep track and analyze common set off points, but also so that my readers can learn more about Ella. Maybe you have an Ella. maybe you know someone like her, or a mom who has a daughter like her.


Recently, we celebrated Maddie's 6th Birthday. While I realize that loud noise can be an assault to Ella and cause her protective sense to go into overdrive.. she thrives on socialization, and rarely has any problems in loud environments that involve playing. I realize that the gifts and party for Maddie may have given her cause to feel jealous. But I don't really think those factors are large contributors to her meltdown during the party.

Situation: The partygoers are assembled in Ella and Maddie's room. They are all playing with the princess Barbies that Maddie received as gifts and the ones we already have. There is a squabble between Ella and her little sister Annelise (age 3) over a crown for a Barbie. Ella falls apart, screaming and crying about how Annelise stole her doll's crown. I ask Annelise if she took it, and she said yes. Ella yelled that I should make Annelise give it back. I asked to give it back and Annelise said no. Ella freaked out and lunged for the crown, and Annelise shrank back in fear.

I told Ella to back off and calm down, and that I would get the crown. Ella continued to howl about the crown, and I told her that she needed to go into another room and pull herself together, and that she should come back when she was calmer. She harumphed off angrily, still crying. I suggested that she use her time to do some of the exercises and techniques that her occupational therapist has shown her to do when she is feeling out of control. I suggested wall pushups, and she refused, and said that she wasn't going to do any of those things. She was out of the room for less than 5 minutes, and returned. She fell apart again within moments, this time about a different doll, I think. She was clearly not composed enough to join the group, so I told her to leave the room again and come back when she had pulled herself together. She came back a second time, and was able to keep herself composed for the rest of the party.

I was trying to coordinate a group picture, and left the room briefly to address her both times she left. My husband and the other adults were in another part of the house.

I was surprised that she showed her meltdown to her friends. I suppose it was because she was in her own house, but she had never pitched a big fit before in front of her friends, or Maddie's friends. They were all very confused about why Ella would throw such a fit, when the older girls, ages 8 and 7, were well able to share the dolls and make suggestions to help pacify or distract the younger girls, aged 3-5.... those same suggestions were made to Ella during her fits, but she did not accept them, and the 3-5 yr olds did.

Last Sunday, my husband was out of town. I took the kids to church, and was under the mistaken impression that I was to help out in the 2 yr old room during the worship service. I had told the girls that we would be in there rather than in church. I discovered that I did not have to work in there, and told the girls that we would be attending worship. Maddie pitched a little fit and said she was really hungry and couldn't we go get lunch instead. Ella started freaking out and sat on the floor in the hallway and refused to move. I had to threaten the loss of television for the day to get her to stand up, after trying several times to get her to obey without the threat. She came inside and sat down with Maddie and I after the singing. She harumphed into her seat, and I told her to watch her attitude. She threw her croc shoe at me. (We sit on the front row on our side of the church, so her activity was not shielded by rows of pews). I took her arm and again told her to get control of herself, and she reached over and pinched my arm hard. I asked the people behind us to watch Maddie, and I took Ella out into the hall. I expressed my frustration and displeasure to her over her actions. I told her that I understood that she was expecting to be in the 2 yr old room and that plans had changed and that I knew it was difficult for her to get adjusted, but that she needed to try. She refused, and slid down the wall to the floor. She told me she wasnt going to get up. I took TV away for several days as a consequence. She finally decided to come sit down. She drew pictures for the rest of church.


We had no more issues until we went to Target around 5:20 that afternoon. Before we left our friend's house, Ella mentioned that she had sweated through her shirt and that she was starting to stink. I told her she could get another shirt while we were at Target. On the way there, I had a discussion with the girls and told them that we only had a short time to shop, so we would not be late for choir at church. Everyone said that they understood and that there would be no tantrums about not being able to find something they wanted in the dollar aisle.

We spent the first 10 minutes in the girls clothing section, with Ella trying on shirts over top of her tshirt. She was becoming more and more agitated that she couldnt find a shirt. I suggested doing push fives with me there in the store, which is an activity that her therapist suggests to help get her organized... we lock fingers and push against each other. She refused and began to get more out of control. Ella fell on the floor, weeping about not wanting to stink. She stood up when I told her to, but continued to wail as we walked through the store, and threatened to run back to the girls department alone if I wouldnt let her get a shirt. I allowed Ella to go look for shirts while I was across from the department in the dollar aisle. She took ten more minutes and had one more breakdown about not finding a shirt until she finally found one.

I realize that because I had told her she could get one, she expected that she would be coming out with a shirt, and that making her leave the department seemed like a change in plans and a personal affront to her dignity that she wouldn't get a shirt. I indulged her looking for more than twice the amount of time I was willing to take to find a shirt, and I was irritated that she felt that her finding a shirt was more important than us being on time to choir where I was supposed to be helping out.

Overall, Im not sure I feel like she is having more breakdowns than usual.. I think she probably has at least one a day, and some days as many as 3. It is just that she is having fall on the floor, weeping tantrums in public, and the disparity between her actions and her age is just getting more pronounced. I recall that in April, we had a trip to the store much like this, where she was on the floor in the checkout lane as well as between the exit doors. We had another fit like this in Walmart about a year ago where I was having to drag her along as she held onto the handle on the cart and refused to make her feet walk and drug between my feet. This does not happen every time we go out. It doesnt happen at the end of the day more often than at the beginning of the day. It is almost always about her rigid thinking about what is going to be happening and how something has changed.. and it is also the fact that once she starts throwing a fit, she cannot stop herself and ends up getting more and more consequences piled on her as she continues to say terrible things, or punch me in the chest, or throw a shoe at me, or whatever.

Considering that her younger sisters have never thrown even one fit each in public, whether with Ella or while Ella was at home, it bewilders me how she might just be a brat and want her own way, etc. Her therapist would likely point to sensory overload, difficulty with transition, rigid thinking, and sensory modulation dysfunction issues when looking at these situations. And while I agree that each might play a part, there is a point at which I guess I feel like the fact that she is 9 would give her some degree of maturity, especially in public. We certainly have fits like this at home, but 1) my mama skills are not on display at home and 2) I can send her to another room to calm herself (even if I have to escort her there with her hands wrapped around my leg and hold the door shut myself.) I am curious about whether her emotional maturity is also much lower than her chronological age and if I should have different expectations for her behaviour, like that she reacts more like a 3-5 yr old most of the time, and try to work with her differently because of that.

It is possible that her hormones are at work here, but we have had these same fits for years. I think we are in a season where they are coming more often, but it waxes and wanes. When she is having a hormonal day, she sheds more tears and seems much more sad when she melts down. Not so much tantrum and anger 3 year old. Both situations, at the party and at Target, were much more 3 year old looking to me.
Thanks for reading. I will post more positive things about Ella soon, but this was on my mind to share today.

Sensory Processing Disorder

I just wanted to post about this disorder, as it is one of the issues we deal with concerning our oldest child.

Ella was a high need baby (if you are unfamiliar with this term, here is a link to a checklist about that, sometimes referred to as fussy, intense babies who don't sleep! http://www.askdrsears.com/html/5/t050400.asp ) and I don't think ALL high need babies turn into children with sensory issues, but I think a fair amount do.

If you have not heard of Sensory Integration Disoreder or Sensory Processing Dysfuction, think of it sort of like dyslexia, but related to processing sensation rather than words and numbers. That's really simplistic, but gives somewhere to start. Great information can be found at these sites:

http://www.sensory-processing-disorder.com/index.html

and

http://www.kid-power.org/sid.html

We first wondered about sensory issues with Ella because she hated having dirty hands and would ask us to clean her hands multiple times during a meal, even as a young toddler (hand! hand! hand!), and she would not eat meat. She seemed to have difficulty as preschooler in figuring out how to clean up after herself (she would get lost if you told her to put the books n the shelf, the clothes in the hamper, and the toys in the toybox), and when Maddie was old enough to put her own velcro shoes on, Ella would have trouble understanding how to coordinate taking her shoes off and switching them to the right feet, but Maddie at 18 months understood and executed it well.

Ella had some seizures as a 14 month old and a 4 yr old, and she had yearly EEGs and MRIs. At her 5 yr old MRI, we found that she had a low level of myelination in her temporal lobes, and I started being a bit of a mama bear about finding out why she had this low amount and what that meant for her. We had an evaluation done when she turned 6, and along with gross and fine motor delays, her team of specialists decided that she had significant enough sensory issues to warrant Sensory Therapy along with OT and PT. Sadly, we can't afford sensory therapy as it is not covered by insurance, but it said a lot to me that they recommended therapy for it.

The biggest things that are difficult on a daily basis for us are her ways of making her needs known (often tends to either whine or throw a tantrum or accuse people of mistreating her or wanting her to hurt, be hungry, be sad, or whatever), hair shampooing with screaming and crying, lack of willingness to eat meat or try new foods with meat in them, clothes are too tight, show her belly, too itchy, too small, too big, tooooo something!, lack of desire to do outside play as it makes her too tired, poor posture and muscle tone as well as fine motor control get frustrating when doing school, and just in general, reaction to situtions out of proportion to stimulus!!!!


I read a great book called "The Out Of Sync Child" that really validated my suspicions about her issues, and showed me that her quirks all sort of fit into two categories, tactile defensiveness and proprioceptive/vestibular.

SIGNS OF TACTILE DYSFUNCTION:

1. HYPERSENSITIVITY TO TOUCH (tactile defensiveness):

__ becomes fearful, anxious or aggressive with light or unexpected touch

(Ella reacts with fight or flight to this and may strike out)

__ as an infant, did/does not like to be held or cuddled; may arch back, cry, and pull away

__ distressed when diaper is being, or needs to be, changed

__ appears fearful of, or avoids standing in close proximity to other people or peers (especially in lines)

__ becomes frightened when touched from behind or by someone/something they can not see (such as under a blanket)

__ complains about having hair brushed; may be very picky about using a particular brush

(at 7 Ella still cries when her hair is brushed and screams when being shampooed)

__ bothered by rough bed sheets (i.e., if old and "bumpy")

(has specific bed sheets, heavy for weight, and often sleeps on the floor)

__ avoids group situations for fear of the unexpected touch

__ resists friendly or affectionate touch from anyone besides parents or siblings (and sometimes them too!)

__ dislikes kisses, will "wipe off" place where kissed

__ prefers hugs

__ a raindrop, water from the shower, or wind blowing on the skin may feel like torture and produce adverse and avoidance reactions

__ may overreact to minor cuts, scrapes, and or bug bites

(elevate the limb! cancel social engagements!!)

__ avoids touching certain textures of material (blankets, rugs, stuffed animals)

__ refuses to wear new or stiff clothes, clothes with rough textures, turtlenecks, jeans, hats, or belts, etc.

(and will remember uncomfortable clothes still in he closet from a year ago!)

__ avoids using hands for play

__ avoids/dislikes/aversive to "messy play", i.e., sand, mud, water, glue, glitter, playdoh, slime, shaving cream/funny foam etc.

(absolutely)

__ will be distressed by dirty hands and want to wipe or wash them frequently

(absolutely)

__ excessively ticklish

(this too)

__ distressed by seams in socks and may refuse to wear them

(ys yes yes, seamless socks are the answer!!)

__ distressed by clothes rubbing on skin; may want to wear shorts and short sleeves year round, toddlers may prefer to be naked and pull diapers and clothes off constantly

(has funky textured clothes, prefers skirts and loose yoga pants, and no turtlenecks or lacy sleeves or neckline)

__ or, may want to wear long sleeve shirts and long pants year round to avoid having skin exposed

__ distressed about having face washed

__ distressed about having hair, toenails, or fingernails cut

__ resists brushing teeth and is extremely fearful of the dentist

__ is a picky eater, only eating certain tastes and textures; mixed textures tend to be avoided as well as hot or cold foods; resists trying new foods

(does not eat meat, resists trying new foods)

__ may refuse to walk barefoot on grass or sand

__ may walk on toes only

(Ella toe walked for so long that she has permanently shortened heel cords and wears night braces to elongate them)


3. POOR TACTILE PERCEPTION AND DISCRIMINATION:

__ has difficulty with fine motor tasks such as buttoning, zipping, and fastening clothes

(Ella's manual dexterity scores are more than 2 standard deviations below the norm)

__ may not be able to identify which part of their body was touched if they were not looking

(yep)

__ may be afraid of the dark

__ may be a messy dresser; looks disheveled, does not notice pants are twisted, shirt is half untucked, shoes are untied, one pant leg is up and one is down, etc.

__ has difficulty using scissors, crayons, or silverware

(scissors especially, and handwriting is not age appropriate)

__ continues to mouth objects to explore them even after age two

__ has difficulty figuring out physical characteristics of objects; shape, size, texture, temperature, weight, etc.

__ may not be able to identify objects by feel, uses vision to help; such as, reaching into backpack or desk to retrieve an item

(if she cant see her hands, she has trouble figuring out what they are doing or feeling)



VESTIBULAR SENSE: input from the inner ear about equilibrium, gravitational changes, movement experiences, and position in space.


SIGNS OF VESTIBULAR DYSFUNCTION:

1. HYPERSENSITIVITY TO MOVEMENT (over-responsive):

__ avoids/dislikes playground equipment; i.e., swings, ladders, slides, or merry-go-rounds

(took her a long time to enjoy things besides swings and slides)

__ prefers sedentary tasks, moves slowly and cautiously, avoids taking risks, and may appear "wimpy"

(yes, doesnt want to risk take and is afraid of appearing clumsy)

__ avoids/dislikes elevators and escalators; may prefer sitting while they are on them or, actually get motion sickness from them

__ may physically cling to an adult they trust

__ may appear terrified of falling even when there is no real risk of it

__ afraid of heights, even the height of a curb or step

(has trouble navigating these things)

__ fearful of feet leaving the ground

__ fearful of going up or down stairs or walking on uneven surfaces

__ afraid of being tipped upside down, sideways or backwards; will strongly resist getting hair washed over the sink

__ startles if someone else moves them; i.e., pushing his/her chair closer to the table

__ as an infant, may never have liked baby swings or jumpers

__ may be fearful of, and have difficulty riding a bike, jumping, hopping, or balancing on one foot (especially if eyes are closed)

(at 7 still has difficulty with a bike, has training wheels and leans terribly to one side, as her muscle tone is not good in her hips and back, and her left side is weaker than her right)

__ may have disliked being placed on stomach as an infant

__ loses balance easily and may appear clumsy

(and her middle name is Grace, we really work on this!!!)

__ fearful of activities which require good balance

(yep)

__ avoids rapid or rotating movements

3. POOR MUSCLE TONE AND/OR COORDINATION:

__ has a limp, "floppy" body

__ frequently slumps, lies down, and/or leans head on hand or arm while working at his/her desk

(yes, as does her father)

__ difficulty simultaneously lifting head, arms, and legs off the floor while lying on stomach ("superman" position)

__ often sits in a "W sit" position on the floor to stabilize body

(did this until she as 6 and we were told she shouldnt be doing it!)

__ fatigues easily!

(you have no idea!)

__ compensates for "looseness" by grasping objects tightly

__ difficulty turning doorknobs, handles, opening and closing items

(yep)

__ difficulty catching him/her self if falling

(this too)

__ difficulty getting dressed and doing fasteners, zippers, and buttons

(took a good long while, also related to manual dexterity)

__ may have never crawled as an baby

__ has poor body awareness; bumps into things, knocks things over, trips, and/or appears clumsy

(yep)

__ poor gross motor skills; jumping, catching a ball, jumping jacks, climbing a ladder etc.

(yes, at 6 had delays to between 36 anbd 48 months old)

__ poor fine motor skills; difficulty using "tools", such as pencils, silverware, combs, scissors etc.

(yes)

__ may appear ambidextrous, frequently switching hands for coloring, cutting, writing etc.; does not have an established hand preference/dominance by 4 or 5 years old

(yes, she does beginning cartwheels and she bats lefthanded, can write with both hands)

__ has difficulty licking an ice cream cone

__ seems to be unsure about how to move body during movement, for example, stepping over something

(yes, motor planning)

__ difficulty learning exercise or dance steps

(this is getting better with age and practice)

PROPRIOCEPTIVE SENSE: input from the muscles and joints about body position, weight, pressure, stretch, movement, and changes in position in space.

SIGNS OF PROPRIOCEPTIVE DYSFUNCTION:


1. SENSORY SEEKING BEHAVIORS:

__ seeks out jumping, bumping, and crashing activities

__ stomps feet when walking

(yes, walks on her heels hard)

__ kicks his/her feet on floor or chair while sitting at desk/table

(constantly)

__ bites or sucks on fingers and/or frequently cracks his/her knuckles

__ loves to be tightly wrapped in many or weighted blankets, especially at bedtime

(yes!!!)

__ prefers clothes (and belts, hoods, shoelaces) to be as tight as possible

(shoelaces!)

__ loves/seeks out "squishing" activities

(loves to be steamrolled)

__ enjoys bear hugs

__ excessive banging on/with toys and objects

__ loves "roughhousing" and tackling/wrestling games

__ frequently falls on floor intentionally

(the rest of these sound like her younger sister, Lily!)

__ would jump on a trampoline for hours on end

__ grinds his/her teeth throughout the day

__ loves pushing/pulling/dragging objects

__ loves jumping off furniture or from high places

__ frequently hits, bumps or pushes other children

__ chews on pens, straws, shirt sleeves etc.

. DIFFICULTY WITH "GRADING OF MOVEMENT":

__ misjudges how much to flex and extend muscles during tasks/activities (i.e., putting arms into sleeves or climbing)

__ difficulty regulating pressure when writing/drawing; may be too light to see or so hard the tip of writing utensil breaks

(often, but this has gotten better with practice)

__ written work is messy and he/she often rips the paper when erasing

(nearly every day)

__ always seems to be breaking objects and toys

__ misjudges the weight of an object, such as a glass of juice, picking it up with too much force sending it flying or spilling, or with too little force and complaining about objects being too heavy

__ may not understand the idea of "heavy" or "light"; would not be able to hold two objects and tell you which weighs more

__ seems to do everything with too much force; i.e., walking, slamming doors, pressing things too hard, slamming objects down

(all the time)

__ plays with animals with too much force, often hurting them

(also, she would often not understand how to remove her hand, and might push the animal to be able to pull her hand back)

1. HYPERSENSITIVITY TO ORAL INPUT (oral defensiveness):

__ picky eater, often with extreme food preferences; i.e., limited repertoire of foods, picky about brands, resistive to trying new foods or restaurants, and may not eat at other people's houses)

(absolutely a small repetoire of foods, but lots of veggies and fruits, and most breads and pastas are ok... but meats, meat dishes, main courses, those are hard)

__ may only eat "soft" or pureed foods past 24 months of age

__ may gag with textured foods

(absolutely, even at age 7)

__ has difficulty with sucking, chewing, and swallowing; may choke or have a fear of choking

__ resists/refuses/extremely fearful of going to the dentist or having dental work done

__ may only eat hot or cold foods

__ refuses to lick envelopes, stamps, or stickers because of their taste

__ dislikes or complains about toothpaste and mouthwash

__ avoids seasoned, spicy, sweet, sour or salty foods; prefers bland foods

(yes indeedy)

SOCIAL, EMOTIONAL, PLAY, AND SELF-REGULATION DYSFUNCTION:

EMOTIONAL:


__ difficulty accepting changes in routine (to the point of tantrums)

__ gets easily frustrated

__ often impulsive

__ functions best in small group or individually

__ variable and quickly changing moods; prone to outbursts and tantrums

__ prefers to play on the outside, away from groups, or just be an observer (no)

__ avoids eye contact (no)

__ difficulty appropriately making needs known

(yes to all of the above except those two I marked), and especially this last one, tends to either whine or throw a tantrum or accuse people of mistreating her or wanting her to hurt, be hungry, be sad, or whatever)

SELF-REGULATION:

__ excessive irritability, fussiness or colic as an infant

__ can't calm or soothe self through pacifier, comfort object, or caregiver

__ can't go from sleeping to awake without distress (waking was ok)

__ requires excessive help from caregiver to fall asleep; i.e., rubbing back or head, rocking, long walks, or car rides

(yes to the above)

Again, just wanted to share. Do any of the above sound like your child? I'd love to talk to you if it does!