1. Ramesh Mehay Programme Director (Bradford VTS) (based on work by Dr. Christopher Green, Nottingham) Behavioural Problems in Under 5s

2. Either can! Child with a difficult temperament Demanding, hard to satisfy, low frustration tolerance, explosive, nagging, poor sleeping How the parent moulds the child and this is influenced by the living environment eg unemployment, illness, lack of support

3. Can you think of any? 1. To grab parents attention Hijack us with an antisocial act 2. They have less sense than their parents realise Under 3s esp are impatient, interrupt, shove etc 3. They dont like separating from their parents After 7m, want their mums (even sleep with parents), until age 3-4y, made worse by stress at home, illness, marriage split 4. They are reacting to some stress in the environment They dont know why parents are stressed, tired etc, but they can sense the air in the atmosphere

4. Out of step children can make good parents appear incompetent So, dont always assume bad parenting! But also dont assume nastiness in under 3s; they just dont think! Consistency is all important: rules that stand today must still stand tommorrow Before creating a scene, ask yourself if it is really worth it. Most discipline needs to be subtle; children respond to our tone of voice, closeness, touch, and body language. These positive methods are much more effective than punishment and pain!

5. KEEP CALM Be selective what you respond to: let unimportant behaviours pass, dont nag/pick/stir, discipline from a platform of peace ENCOURAGE GOOD BEHAVIOUR, discourage the bad = Pavlovs dogs. Dont make too much of a fuss of the bad. Often behaviours which annoy us the most are there because we have responded, rewarded and built them up. BE POSITIVE Adults and children are happiest when they sense consistency. Dont let any amount of whingeing change your mind. Remember: the big people are back in charge. Say what you mean and mean what you say. WHEN ALL ELSE FAILS Dont lose control and get in unnecessary fights. When parents lose it, there are rarely any winners. When about to snap, put the child briefly in their room, go outside and put some space between the warring parties.

6. Hes not eating much doctor and Im worried. He wont touch normal food, only chocolate and junk food. And I am worried he wont grow properly Child: age 2 ½, alert and active.

7. Look at growth charts: make sure he is growing fine. There are two sorts of child: those who eat everything and those who pick, fuss and fiddle Food is the fuel that powers our little children. If they are growing, healthy and full of energy, they are probably getting plenty.

8. Reassurance first – explain how common, reflect of weight, height, activeness, that mum is not a bad parent Start with a foundation of bread, cereal and pasta – food which most young uns like Now add a bit of protein (eg chicken, egg, cheese), some Calcium (milk, cheese, yoghurt) Add fruit/fruit juice and vegetables when accepted When big meals are not taken, healthy snacks and drinks are quite adequate Dont force feed food (=Pavlovian bad behaviour and youll have a tough time) If concerned, keep a diary and tot up what they eat REMEMBER, milk is a food. On a milk diet, tiny calves grow into big cows: explain that. With milkaholics who eat little solids, halve the milk allowance and see what happens.

9. Hes up three or four times during the night doctor and Im exhausted. I have to work next day stacking shelves at Sainsburys and start at 6 in the morning every day. Its making me bad tempered and the other half aint happy about it neither. Can you give me some medicine to make him sleep?

10. Medicine is never the answer. Explain: little babies wake 1-2 a night until age 3 months (but sometimes til end of age 1y). Better to accept the inevitable rather than resenting and wrecking important early relationships If a toddler wakes for comfort or a drink this is okay PROVIDING it does not cause excessive hassle in the household If it starts taking over and stresses the parents, take a firm stand. Most sleep problems are attempts to gain parents attention.

11. Set a regular bed time If child is going to bed late, bring time forward by ¼ hour each night Bed time routine is important Eg have a bath, feed, special quiet song, a last cuddle before bed Set up the bedroom Settle the baby in rather than letting fall asleep on settee; put baby in cot when drowsy rather than when fully alseep If child is upset when you leave Try waiting a few minutes before going back, tuck them in quietly and leave again. Repeat this checking until child settles If child wakes and cries Check for discomfort/nightmares, then do checking procedure above

12. Some Ideas Go to the cot promptly If you use a dummy, replace it Pat the baby gently and make soothing noises Leave the baby for a few minutes then return and comfort again if necessary Repeat this comforting and leaving until settles Avoid Leaving your baby to cry for a long time Picking up your baby as soon as he cries (will otherwise learn to cry just to be lifted)

13. Naps are okay, most need around 2 per day Preferably allow naps in the earlier part of the day If you are planning on a 7pm bed time, try to avoid a tea time nap

14. Most sleep problems in young children arise because of changes in routine eg moving house, birth of another baby, illness You may need to re-establish a new routine Its normal : A) for a child not to want to go to bed when you want them to B) for babies to wake up at odd hours C) for a toddler to wake at midnight and want to talk and play D) for a young child to be ready to start the day at 5am

15. Establish new routine A bed time story, favourite toys in bed It will take more than a few nights for a child to learn new habits If you want your child to behave in a certain way, then you must set the rules and stick to them Both parents need to stick to the plan Make bed time a happy and relaxed time Not a punishment; boisterous romps before bed time dont exhaust children but just make them more excited Explain: most children need less sleep than parents want them to have. If were honest, we want children to sleep ALL NIGHT for our sake, not theirs. We NEED the rest from them.

16. She is bad doctor. I mean, when she doesnt get her way she throws wobblies that are really embarrassing. No matter how much I should and scream back at her she wont stop Shell even throw things and smash them up. Ive had enough. I know she looks sweet as pie here but she can be a monster.

17. Toddlers have to discover all sorts of things they can't yet do or mustn't do and feelings that they cant yet manage by themselves without tears or tantrums. Some children can't bear to feel little and helpless. They refuse to accept that there are things they can't yet manage. Being bossy can be a way of covering this up and trying to make others feel small.

18. Reassure if the behaviour isnt all that bad: babyish' behaviour is hard to bear because it makes us worry that things are going backwards. Give in gracefully sometimes over things which don't really matter. That way she will get the chance to learn what it is to back down. There are going to be plenty of times when she wants something impossible or dangerous. So there will still be opportunities for her to learn about "no" and for you to learn to cope with her tears. It is worth being truthful about new situations or child minding arrangements so that they don't feel taken by surprise or tricked. Allow plenty of time for settling in and a certain amount of fussing. And be prepared to take it seriously if your child really feels he isn't ready for a new step forward. It is worth wondering if he's under some particular stress.

19. Retain control: children learn by example so if they never see us struggling to cope with our frustration or worry how can they ever learn that is possible to be distressed or angry without throwing a tantrum? Unless she's doing something dangerous count to 10 before taking any action at all. Try not to get drawn into an argument about exactly what started it. She really is beyond reasoning with. Don't ask more of her than she can manage. Coping with her temper doesnt mean trying to stop her being angry, it means coping with how angry she makes you feel. Try to avoid saying things just to hurt her back- especially threats of leaving home or having her put away. You may not mean it but she doesn't know that.

20. Firmness is important but so are understanding and tolerance. Simply telling a child to behave better doesn't give them the strength to control their feelings. They can only learn slowly how to share, wit and accept "no". And they learn this by example. Don't worry that she's growing up to be a monster. The temper tantrums of a 2 and 3 year old will start to tail off but only slowly. It will take 2 or 3 years. Remember her tempers she's learning important lessons about herself - and both of you are practising for when she's a teenager!