If your toddler is biting other children, it may mean more appropriate methods are needed to satisfy a need for oral stimulation. Or it could mean your chid is tired, frustrated or at the end of her rope.By

By Douglas Albrecht, Ph.D.

In the last Babies to Big Kids blog from my colleague Lorenzo Azzi (“Managing meltdowns”), a parent commented specifically about dealing with biting. Many of Dr. Azzi’s suggestions apply to biting issues, and I wanted to offer up some additional help and support for parents of toddlers who may be going through the biting phase.

First, let me assure you that biting is a very common behavior in children. But, no one wants their child to be known as “the biter” and I’m sure that does not make it any less frustrating or concerning to you as a parent.

From my perspective as a clinical psychologist, when I talk to parents about any kind of challenging behavior their child is exhibiting — whether that is biting, hitting or tantruming — I think it is important to ask, “What is this behavior really about?” and “Why is my child biting?” in order to support and teach them more effectively.

Why Does My Toddler Bite?

There are usually two basic issues related to your child biting:

1) He or she is dealing with something emotional and overwhelming or

2) There is a physiological need they are filling by biting.

Let’s take a closer look at each reason.

Toddlers tend to bite because their emerging language skills are less effective, and they have difficulty communicating their need, wish or desire to others. They may also be feeling tired and end of their rope.

At this age, most children also have difficulty sharing. This is a BIG one because your child’s concept of sharing at this age is, “If I had it, it’s mine, and if I had it before and you are playing with it now, it is still mine.”

Taking a look at the physiological reasons for biting, your child may be teething or just may need what we call “oral stimulation.” Some children need more of this input than others and may like to chew on crunchy veggies, or really like having their teeth brushed as well — this is very normal behavior.

What Can I Do To Stop the Biting?

Children, especially toddlers, need three important things every day: 1) good sleep 2) a healthy diet and 3) the opportunity to get out energy in an appropriate way. Ensuring your child has these needs met will go a long way in fostering positive behaviors and limiting frustrations.

When a biting incident does occur, remain calm, be patient and don’t overact. Remove the child who did the biting and get her away from the cause of the reaction. Say to her a few simple words that she will understand, such as “We don’t bite” or “Biting hurts.”

You and your child should also spend some time with the person who was bitten, making sure they are okay. This will help create a sense of empathy in your child and an awareness of others.

After the incident has passed and she is calm, it is time to help teach her to use simple words to express her emotional experience. Say, “It can be hard to share toys with your friends,” or “I know you are tired,” to help her put language to the emotional experience.

Biting behavior won’t change overnight; but if you have a good game plan ahead of time, respond calmly and help your child learn to voice her frustrations through language, instead of biting, you will see this behavior diminish.

Douglas Albrecht, Ph.D., is a licensed clinical psychologist and the clinical director for the Good Fit Counseling Center at Southwest Human Development, where he provides treatment, assessment, consultation and supervision services for infants, toddlers and their families. His expertise encompasses infant/toddler mental health, parent-child relationships, play therapy, attention deficit hyperactivity disorder (ADHD) and attachment and bonding.

We’ve all witnessed a child (sometimes our own) in full meltdown mode, as well as the tantrum that inevitably accompanies it. It can happen anywhere — like the grocery store checkout line — at any time. All you really want to do is quickly end the fit so your child calms down.

As a clinical psychologist specializing in infant and toddler social emotional development, I hear firsthand from parents puzzled as to how to respond to tantrums — especially given how much misinformation there is about why children throw fits.

What is a tantrum?

There is a huge misconception that tantrums are your toddler’s attempt to manipulate you into getting what he or she wants. While this might be true in a very small number of cases, I can assure you that developmentally, your toddler isn’t cognitively sophisticated enough to intentionally manipulate you.

A tantrum is really the behavioral manifestation of your child’s emotional response or feelings. That feeling might be genuinely sad, confused, angry or scared and he’s crying and throwing a fit because the intensity of that feeling overwhelms his still unsophisticated capacity to cope with big feelings.

Over time, children develop the capacity to regulate their emotions and we as parents can help teach children how to regulate emotions in a positive way. Believe it or not, tantrums are a perfect opportunity to foster this learning process with your child.

What should you do when your child is having a tantrum?

When you have the mindset that your toddler is doing this to manipulate you, this likely leads to anger and to punitive measures like spanking, ignoring or taking something away; none of which are helpful to your child or teaches appropriate ways of managing “big feelings.”

Instead, if your toddler has a feeling that he doesn’t know how to deal with on his own, start by trying to understand what feeling he is experiencing and help him to regulate that negative feeling using the following steps:

Step 1: Be empathetic and calm

Show empathy and calmly demonstrate that you know how your child feels. Say, “I can see you are really sad right now,” or “That made you really angry when your sister knocked down your tower of blocks.”

As you are voicing empathy, just sit with your toddler. Hold him, gently rock him or rub his back and just sit with him in a calm, reassuring way.

Step 2: Practice self-calming skills

When you can tell your toddler is starting to calm down and has regained some control, THEN you can help teach him how to deal with his emotions. Try telling him, “When we get upset we can breathe in together” or “Let’s count to 10 together.”

Using the example of his sister knocking over his blocks, calmly explain to him, “I can tell that made you really upset. One thing we can do when that happens next time is build a different one, or build it again.”

Also, give him some words to use to express himself such as; “You didn’t like it when she knocked your tower down.”

When a child has the repeated experience of a parent or caregiver being able to sit with them and calm them when they have a negative emotion, they learn very quickly, even at a very young age, that they can recover from feeling bad and this important person can help them achieve this. Toddlers who have internalized this feeling often experience fewer and much shorter tantrums.

In fact, if you consistently practice these steps with your child, they will quickly learn to practice self-calming skills and can deal with their emotions in a positive way.

From toddler to teen

As an added benefit, helping your toddler cope with tantrums at a young age can have a far-reaching impact on your relationship with your child, even into their teenage years.

Case in point: If you ignore your child when he throws a tantrum, or you send him to his room, the message you send is that “when you have a problem I can’t be with you and can’t tolerate you; you need to be on your own.”

Conversely, if you practice the steps above, your child’s brain becomes hardwired that you are the person they can come to when they are having a problem, and that you will be calm and sensitive — no matter what their age or problem.

Lorenzo Azzi, Ph.D. is a clinical psychologist specializing in infant and toddler social emotional development at Southwest Human Development, where he provides consultation to families via the Nurse Family Partnership program, Early Head Start program and the Good Fit Counseling Center — Arizona’s only mental health center for young children. He also serves as faculty for the prestigious Harris Infant and Early Childhood Mental Health Training Program.

Pediatricians encourage child-centered play, where you follow your baby's lead.

By Daniel B. Kessler, M.D.

You might be thinking, “What’s to learn? I’ve mastered peek-a-boo!” But what you may not know is how the power of child-centered play can unlock a whole new world for your baby.

The practice of child-centered play is strongly encouraged by pediatricians because we see a significant correlation between this activity and language development, increased independence and attention span, and many other cognitive benefits for your baby.

So what exactly is child-centered play and how can you harness the benefits of play for you baby?

CHILD-CENTERED PLAY

Child-centered play is a way for you to play with your baby where you follow her lead and pace in whatever activity she chooses. For example, if she’s blowing raspberries with her mouth, you want to imitate this same action and sound and narrate the activity for her.

By mirroring your baby’s actions, she is learning that she’s important and that you are paying close attention to what she’s doing. But it isn’t enough to simply imitate your baby as the narration and verbal description is the key to child-centered play.

The easiest way to master this is to pretend you are the color commentator or play-by-play announcer, on the baby’s interaction. Describe her actions and encourage her by saying, “Wow, you are making a raspberry. What a great raspberry!”

By describing the play, you are not only adding to her vocabulary, but you are also expanding her knowledge of colors, letters, numbers and the whole world around her.

And keep the conversation going! As she responds with noises and words of her own, verbally reflect your baby’s feelings by saying “you are having fun making noises and raspberries.”

FIVE MINUTES OF PLAY A DAY

Just five minutes a day of child-centered play can significantly benefit your baby’s language and development. Here are 10 simple steps to help you master child-centered play with your baby:

1. Follow the child’s lead and pace in whatever activity they choose
2. Get down on the ground with the child
3. Imitate their play
4. Describe their actions – “You are using green paint”
5. Verbally reflect the child’s feelings – “You seem to enjoy the red truck”
6. Encourage the child – “You threw that ball far”
7. Be enthusiastic through your words and facial expressions
8. Expand play, but do not change direction or theme of play
9. Express interest in who they are and what they are doing
10.  Listen and be present!

Daniel B. Kessler, M.D.

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

In my last blog, “The Medication Equation,” I talked about fears and hesitations you may have about the all-important decision of placing your child on medication. As a follow up, given the complexities of this decision, I’d like to offer answers to some of the most common questions developmental and behavioral pediatricians like myself receive surrounding meds.

The usual disclaimers should apply to this information as this is not intended to be medical advice for your child. Rather, it is intended as a great conversation starter with your own pediatrician.

Q: Why does the doctor change my child’s medication?

A: Although much is known about the use of medications to treat certain conditions like ADHD, each individual situation may involve some degree of trial and error. For example, if one drug fails to help a certain symptom such as hyperactivity, that is no prediction of whether another member of the same class of drugs might not be helpful. Your child is unique and so is his or her body’s response to various medications.

Q: What information should the doctor give me about the medication?

A: The doctor should tell you when the medication is expected to work. Some medications may work in 30 minutes while others may take eight weeks to be effective. You also should be told what side effects might be expected. For example, will the medication make your child sleepy? You should also be told if the medication might interfere with any medication your child is taking or might take in the future.

Q: How do I know if the medication is working?

A: Your child’s doctor will share what to expect if the medication is helping. You may wish to ask your child’s doctor specific questions such as, “Will it be easier for Amy to concentrate at school?” There might also be a measureable way to assess the effectiveness of the medication for the condition being treated, even if it is just a behavioral questionnaire.

Perhaps the most important point to share with you is that medication should be viewed as just one part of an overall treatment plan for your child – but it may be a very important and useful part! Do not be afraid to ask your child’s doctor for more information, as they are there to help you and your child.

Daniel B. Kessler, M.D.

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

By Daniel B. Kessler, M.D.

As we gear up for the cold and flu season — and the inevitable runny noses that come from holiday travel — parents often ask me questions about medications and their little ones.

They have questions about what medications are “safe” for kids. They wonder if natural remedies are better and how best to administer medications for children to ensure they actually get the full prescribed dose. And the list goes on.

Misinformation and worry

I think there are so many questions surrounding medication for two reasons. First, there is a lot of misinformation about medication, especially in what you read online and perhaps even what you hear from other parents. It can be daunting to wade through this information and determine what is fact and what is fiction.

Second, it is easy to make a decision for yourself to take medication. But as a parent, you weigh this decision very carefully for your child, and rightly so, because you may worry about how long your child will need to be on the medication and what the side effects may be. You may also want to know if there are natural alternatives.

Is natural safer?

With regard to natural remedies, I think there is a misconception as to what “natural” means. Tobacco is natural because it grows in nature but you wouldn’t let your child go near it! So keep in mind that natural doesn’t always equate to something safe for your child.

As a pediatrician, I’m constantly looking at the scientific information that a remedy put forward for a condition actually works — regardless of whether it is found in nature or is man-made.

Many scientists also are taking a closer look at diet and how this can impact certain conditions. While the jury is still out on gluten-free diets or increasing omega-3 fatty acids helping with conditions such as ADHD and autism, I can say without a doubt that all of us should be eating better and that eating more fruits and vegetables of all colors is a good “natural” step parents can take for the health of children.

A team approach

The bottom line when it comes to medications is that every child is different and should be treated as such. Ask lots of questions and work with your pediatrician to understand your child’s unique needs – together you can determine a course of action best suited for your little one.

Daniel B. Kessler, M.D.

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

By Daniel B. Kessler, M.D.

The expression “I slept like a baby” is a funny one because we all know that babies are more prone to waking up throughout the night as newborns.

What many parents may not know is that your baby actually learns to sleep and you are your baby’s best teacher. Here are three tips I give parents when they want to help their baby sleep like a baby.

Teach them what bedtime means

When babies are first born, they can’t distinguish between night and day. Your baby makes those distinctions and begins to sleep more at night based on environmental cues from you.

For example, let’s say you are working and come home past your child’s established bedtime and you want to play with her. You are sending her a very important message that staying up past bedtime is super fun! A message which may have unintended consequences later when she fights sleep because “no way do I want to go to bed and miss fun playtime.”

Be boring

When your baby wakes up in the middle of the night, you want to be as boring as possible. If you need to change her because she’s wet, get it done quickly with little fuss and as little talking or interaction as possible. The same advice applies to a feeding at night. If there is excitement on your part or play with toys, she will confuse nighttime as playtime and won’t easily fall back to sleep. It is the cues from her environment that helps her establish that nighttime is sleeping and boring. She should be thinking, “Mommy is asleep; Daddy and Sister are asleep too, so I guess I need to sleep because no one is around to play.”

Unwind slowly

Restful sleep involves decreasing our general activity level. During sleep we are doing much less. Our body slows down and we want our minds to slow down as well. The best way to do this with your baby is to establish a wind-down routine each night to help pace your day down.

Every parent and every family does this differently. Perhaps you have dinner, give baby a bath, read stories and then it is off to bed. Whatever your routine, help slow down the activity level in the household if possible to give your baby the best opportunity for a restful night’s sleep.

No matter what your family routine is, as a pediatrician and a child development specialist I encourage parents to use wind-down time for reading and not for screen time. Many studies show that screen time is actually stimulating to the brain, whereas reading is a quieting activity. Reading also is incredibly important to help your baby develop language skills and to help her with imagination and creativity, making it an ideal activity.

There’s a reason why as parents you remember the first time your baby sleeps through the night – it’s magical and signifies more sleep for Mommy and Daddy too! Helping your baby sleep well provides a restful night for the whole family.

Daniel Kessler, M.D.

Daniel B. Kessler, M.D., is a developmental and behavioral pediatrician and medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development. His private practice, where he provides evaluation and treatment for children and adolescents, is located at Southwest Human Development.

As a pediatrician, I’m often asked how much freedom children should have regarding eating choices. Conversely, parents want to know what they can do to help influence healthy eating habits.

At Easter Seals Southwest Human Development, we adhere to a proven theory of feeding advice, offered by therapist and registered dietician Ellyn Satter. It’s known as “A Division of Responsibility.”

For infants, you are responsible for what your baby eats. You provide the food, often with the advice of your pediatrician, and for the first 12 months, this is mostly a liquid diet breast milk or formula. Your baby is responsible for how much she eats. Over time, your child takes on more responsibility in what to eat and when.

Following are three tips you can employ to help your child learn this responsibility at the appropriate times, and put them on a path toward life-long healthy eating.

1) Help babies (and yourself) learn to recognize when they are full.

This can be a bit easier when breastfeeding because parents don’t have the sense of exactly how many ounces their baby is eating. To look at the ounce marker on a bottle and have a predetermined sense of “this is how much my baby eats” gives parents the wrong impression.

Instead, your baby should eat until she is full and is expressing that she is done.
Babies may pull away from the bottle, turn their head away from the bottle or display a general disinterest. When you let her tell you that she is done eating, your baby learns to develop a sense of satiety and to stop eating when she’s full.

2) Develop a family meal schedule.

As baby grows into a toddler, you are still responsible for what food is made available and, perhaps equally important when and where it is available. This social structure of meal times is very important to forming healthy eating habits because it provides a sense of “this is when we eat as a family and this time is important.”

It also provides a structure for meal times and snack times, as opposed to allowing a child to graze throughout the day. When food is available all day, children don’t develop their own innate sense of the “tank is full” or the “tank is empty” and don’t stop eating when full.

Parents are also responsible for where the child eats. Many studies support limiting screen time when eating because it distracts our attention from the full feeling and we tend to overeat.

3) Be okay with them not eating.

Even though you pick the food, the time and the place, your child should still be responsible for how much and whether or not he or she is going to eat at all.

What happens naturally is that your child may eat really well at one meal, poorly at another meal and not at all at another meal. If taught to pay attention to their hunger level and to eat what they need at that moment, this is okay and healthy. Don’t force your child to eat.

Instead, pay attention to your child’s intake over the course of an entire week. You will likely find that your child will take what she needs for growth — nothing more and nothing less — which is a healthy habit that will last a lifetime.

Daniel Kessler, M.D.

Daniel B. Kessler, M.D. is medical director of the Children’s Developmental Center at Easter Seals Southwest Human Development.  A developmental and behavioral pediatrician with more than 28 years of experience, Kessler works with a multi-disciplinary team to provide comprehensive, integrated care for young children with developmental and behavioral problems and their families.

By Terrence Matteo, Ph.D.

Your relationship with your child shapes his or her entire life. In fact, the early patterns of interaction you have with your child become wired into his or her brain and creates expectations about the world around them.

You can see then, how important it is to develop a healthy relationship with your child at a very young age.

So how do you communicate with your baby and build a strong relationship?

Your body language, tone of voice and loving touch are important ways of communicating.  But communication is a two-way street and you have to learn how to respond to what your baby is trying to tell you. There are subtle cues a baby provides to teach us about his needs.

Watch, wait and wonder

At Southwest Human Development, we help parents become more aware of their child’s inner experience by helping them slow down, pay attention, and respond thoughtfully to their child.   We encourage parents to play on the floor with their child and:

Watch. We encourage parents to pay attention to their child’s nonverbal communications — facial expressions, sounds and body movements. Does he like to be held a certain way? Does he have a soothing blanket or toy that calms him? Be mindful of his response to your voice and your touch.

Wait. Try to play on the floor with your child every day.  During play, try following his lead instead of directing the play.  Wait to see what your child is interested in; what they are trying to do — and help support their exploration and play.

Wonder. What does he need from you and how you should react to that need? When you wonder about what he is really trying to communicate, you can often respond to the exact need he has; thus building trust.

When you take the time to understand and respond sensitively, you provide your baby with an optimal foundation for life, contributing to an eagerness to learn, a healthy self-awareness, trust and consideration for others.

Terrence Matteo, Ph.D.

Terrence Matteo, Ph.D., is a licensed psychologist and director of the Children’s Developmental Center at Phoenix-based Easter Seals Southwest Human Development, which provides programs and support for more than 135,000 children from birth to age 5 and their families.