Behavioural & Cognitive-Behavioural Psychology

Potty Training the Toddler – Potty Charts, Rewards & Tips

Date: November 25, 2016
Author: Emm
Categories: Age: 2-3 years, Age: General toddler, Behavioural & Cognitive-Behavioural Psychology, Development, Potty/Toilet Training
Comments: 1 Reply

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How we potty trained: Psychology, reward charts, practice!

So we started potty training some time ago, but then lost momentum

The toddler (2.5 years as I write this) is pretty good at going to the potty now at home and if he is not wearing a nappy or trousers. But, if he has nappy and clothes on then he will just continue to use the nappy, not say when he needs the potty, and not use the potty. So I needed to get back on track with the training:

 

Potty training – Stage 2

The toddler is acquainted with the potty now so that’s some of the hard work done. I decided to make a chart where he can see his gains and successes and include rewards and positive reinforcement.

 

The psychology behind it

  • Graded exposure – to the potty (practice) – Child gets used to using the potty and increased skill and confidence with experience working their way up to a final goal (e.g. using potty or big toilet and no longer wearing nappy)
  • Behavioural psychology – rewards and reinforcement
What does this mean? Graded exposure relates to gradually in a step by step manner getting used to something starting with one small step and building on this with bigger steps. You might make an exposure hierarchy which is a ladder of experiences starting with a step that causes only a small amount of change/disruption that would be more manageable, and an experience at the top that would be very difficult to achieve in the first instance (but more manageable after you’ve achieved all the steps leading up to it). Once a step has been mastered any concern or upset about the following step tends to reduce because we learn that it “was ok”, “not as bad as we thought”, we have the experience from the previous step, and so on.
  • Example of steps with increasing difficulty: sitting on potty with clothes on as a first step. Doing a wee on the potty. Doing a number 2 on potty. Not wearing a nappy and using the potty. Using the potty at night time, using the “big toilet”… etc etc

 

Rewards and Reinforcement:
Reinforcement is where behaviour increases. Positive reinforcement is where a behaviour increases because it’s followed by a positive/motivating consequence such as praise or a toy. Negative reinforcement is where behaviour increases because a negative consequence is removed, maybe using the potty prevents wet and soiled clothes, change of nappy, change of clothes (if they don’t like this).

 

The Potty Chart

How we made our potty chart - potty training, how to & psychology

How we made the chart

The potty chart I made is a very lose hierarchy I suppose because I included a point where we ditch the nappy and wear pants (there’s a little photo of a pair of pants at this stage), in the hope that the toddler will be able to go straight to the potty when needed.
The general look is supposed to be a train track which goes down to a station at the end (see the photo of the station at the bottom of the chart which attaches to the toddler’s train track and he can actually play with it). There are trains (rewards) to collect along the way. I spaced these out so that the target behaviour (using the potty) is continually reinforced and rewarded, see more below:

 

How we potty trained: Our big toy reward! Psychology, reward charts, practice!

The “big reward”

  • I spaced the rewards out to keep the toddler motivated – there are several and they start soon on in the process.
  • There is a “big reward” at the end – a train station, which he really wants
  • We talk about the rewards which are trains from Thomas the Tank Engine in the hope that this maintains his attention and reminds him of the aims and potty frequently
  • I ask him frequently if he needs to use the potty and of the reward process – Use potty – Get sticker – get train after so many stickers
  • I keep the potty chart close to the potty so he can see his progress and to act as a reminder
  • The theme of trains and train track is meaningful to him and something he values. It taps into his personal interests.

 

How we’re using the Potty Chart

How we potty trained: Choosing stickers for our reward chart.

Choosing stickers for the reward chart

  • Use potty and get a sticker
  • Toddler picks a sticker and puts it on the chart himself (control, autonomy, increasing interest, ownership etc)
  • Stickers go down the train track towards a reward (toy).
  • Get enough stickers and he gets a toy.
  • Keep going down the track to the BIG reward at the end – a train station

 

Outcomes – what happened…

I wrote the above a few months ago now. We successfully navigated around and down the train track to the station at the end! The focused reward chart was a success. I also liked the idea of keeping the chart up in the living room where the toddler could see it, track his progress and act as a reminder of his success alongside the repetitive and reinforcing potty behaviour. He was very pleased with his station.

 

How we potty trained: Our big toy reward! Psychology, reward charts, practice!

Finally got his big reward! (station)

Wasn’t all plain sailing…

The area of the chart where it says “now wear your pants” didn’t happen – we started with the pants a bit later down the track. Why? Well we used them and we wet them a few times. I wondered if it was a bit too early and if they felt like wearing a nappy. Pants were a new concept for the toddler. So I waited a bit longer until the potty visiting behaviour was more familiar and routine and then we added the pants.
We had a few accidents, but I think this is normal.
But, finally, we are now “potty trained” inside the house for wee! (apart from at night time and long naps where we use a nappy still)

 

 

Next step – potty use OUTSIDE the house!…

(note how I’m breaking this all down into steps – this is also for my benefit! – but if you prefer to do it quicker or all in one go, then that’s a personal choice).

 

Potty training the two year old – psychology and retrospect

Date: January 24, 2016
Author: Emm
Categories: Age: 2-3 years, Age: General toddler, Behavioural & Cognitive-Behavioural Psychology, Development, Potty/Toilet Training
Comments: 1 Reply
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Potty training at 2 years old: Psychological perspectives and a graded hierarchy to encouraging the toddler to use the potty

Our potty

The potty “training” still seems to be going well. I say “training” because I feel like we’re not specifically doing anything, but then I looked back on what we had set up, and, actually I can think some psychological and “set-up” aspects apply.
Firstly, we upgraded the basic boring plastic potty we had previously (that he never sat on) to a fancy Thomas the Tank Engine colourful potty that plays a little song when something is deposited in it. This is a reward in itself. We made the potty interesting and something exciting to sit on by selecting one where he recognises the theme (Thomas), and likes and potentially trusts that brand (because he likes the toy). We set it up so that it wasn’t a toy, though, so he knows there’s a particular function around it. We started to talk more about that “function” and make it part of our every day, normal, conversation by saying things like “mummy is going to the big potty now”, etc, to make the toddler aware that going on the potty is a normal thing people do. I suppose we kind of set up a graded step by step hierarchy as well by:

 

  1. Introducing the potty
  2. Having the potty out in the living room
  3. Discussing that the potty is for doing a wee or poo in, not a toy, and normalizing this process when adults in the house needed to go to the “big potty”
  4. Encouraging the toddler to sit on the potty, with clothes on in the first instance (as he wasn’t sure about it)
    1. offering a reward/reinforcement for just sitting on it (I can’t remember if this was a biscuit or watching his favourite TV show, which also probably reduced any anxiety or concerns because he was distracted by the TV and calmed by his favourite show)
  5. Encouraging the toddler to sit on the potty without a nappy (diaper) on
  6. Encouraging him to sit on it when we thought he might need a wee, e.g. after a bath because that’s when he often does one, and offering a reward for doing a wee – also talking about what reward he would get
    1. offering a reward/reinforcement for doing a wee which was chocolate and now also a reward “coupon”, which the toddler calls “tickets”. He likes the fire engine tickets the most (pictured)

 

Potty training at 2 years old: Coupons, Rewards and Reinforcement; encouraging the toddler to use the potty

Reward “coupon”

We haven’t got to the point yet where the toddler can tell us that he feels the need to use the potty. That is still to come. But, we’ve done very well so far I think!

 

♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦

Also, here’s a complete cut and paste job from a previous post of mine about reinforcement:

Ψ reinforcers = increase frequency/likelihood of a behaviour

Ψ punishers = decrease frequency/likelihood of a behaviour

Ψ Here’s a good page that explains positive/negative reinforcement and punishers – for example, they explain that “punishment” doesn’t necessarily mean there is a harmful or dangerous consequence, it’s a process where a consequence immediately follows a behaviour which decreases the future likelihood of that behaviour occurring. Positive punishment is where a negative consequence is put in place after the behaviour, like sending child to “time out” or telling them off, and negative punishment where a good thing or desired outcome is removed after the behaviour occurs, such as removing cake/sweets/ice cream because the child was “naughty”. Reinforcement is where behaviour increases. Positive reinforcement is where a behaviour increases because  it’s followed by a positive/motivating consequence such as praise, reward, like giving a kid money (positive) for doing chores (the behaviour). Negative reinforcement is where behaviour increases because a negative consequence is removed, such as a kid does his chores (behaviour) to avoid being nagged to do it (negative).

 

 

 

Potty Training the toddler at 2 years old

Date: January 18, 2016
Author: Emm
Categories: Age: 2-3 years, Age: General toddler, Behavioural & Cognitive-Behavioural Psychology, Potty/Toilet Training
Comments: 1 Reply
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Potty training at 2 years old: Rewards and Reinforcement; encouraging the toddler to use the potty

I’m the “number one” engine

So we’ve been attempting to “potty train” the toddler. By potty train I mean buy a potty and hope he sits on it. I’ve not actually developed any formal training schedule. Anyway, some time ago I bought a basic plastic potty. He didn’t like it and only sat on it once or twice I think. Maybe it was too uncomfortable and uninteresting. We upgraded a few weeks ago to an all singing fancy Thomas the Tank Engine potty which is colourful, has a picture of Thomas on the inside and also (apparently) plays a song or noise when he (eventually) deposits something in it!

 

And now something (slightly) more psychological about potty training and shaping behaviours:

So far my attempts have been to encourage him to sit on it for a start. He’s done this. I had to bribe him with promise of a biscuit if he sat on it because he was slightly dubious of the thing (despite it being Thomas related, and even then he kind of thought it was just a new toy). We then upgraded to him sitting on it with no trousers (pants) or nappy, usually after a bath as this is sometimes when he does a wee and has no nappy on anyway. He’s done that too. I’ve promised him chocolate if he does a wee or poo. You could class this as reinforcement I suppose, rather than bribe! Note though, maybe offering food as a consequence isn’t always the best answer but hey ho I’m into new territory here with the potty so I’m winging it. If you want to set up some less food related rewards and consequences schedule there’s some great behaviour charts here for “things I need to work on” (useful for general behaviours and issues) and their potty training section here. The potty training reward coupons look great and i’m going to print some off to give to the toddler appropriately. Yes, suppose I could have done a sticker reward chart too to encourage repetition of potty sitting and eventually wee/poo related behaviour on the potty.
So last night, he apparently did a very small wee in the potty!! Unfortunately, nobody noticed and he didn’t say that he’d done anything . The darned potty is supposed to play a song to alert us to this fact but I think it was too small an amount so it didn’t set the song button off. Fingers crossed he’ll do it again soon though so we can celebrate! Yeah, let’s all celebrate successful weeing!!

 

Potty training at 2 years old: Coupons, Rewards and Reinforcement; encouraging the toddler to use the potty

Reward “coupon”

**update the next day: he did a really small wee in the potty tonight! He had chocolate and a special “coupon” as a reward (pictured, from freeprintablebehaviorcharts.com) Hopefully the coupon is a bit more tangible and longer lasting than the chocolate; he can see it and it will act as a reminder, encouragement and reward for the behaviour.

 

 

 

 

 

 

 

Babies, toddlers, their teeth and the dentist

Date: February 26, 2015
Author: Emm
Categories: Age: 12-18 months, Age: General Baby/Infant, Behavioural & Cognitive-Behavioural Psychology, Teething
Comments: 1 Reply

The dentist, babies, toddlers, and healthy teeth. What is good dental practice for infants?We had our first dentist appointment today! (nearly 14.5 months).

I naively thought it would all go smoothly, but the Little Lovely refused to open his mouth. I sat with him on the chair, with him in my lap. The dentist was very nice and seemed like she had experience in working with small children. She brought out some stickers and tried to gain his interest. He wasn’t very interested. She got a very quick glimpse in his mouth. We tried to encourage him to open his mouth again but he didn’t like it and got upset. The upside of this was that she could see into his mouth again. All that we learnt was that he is still missing his back molars (which we know…), and the dentist said he might be a bit grumpy if they are coming in. She said only to use a very small amount of toothpaste and asked if he had a varied diet. We were only there for about 5 minutes, if that. Oh well. But, she made the good point that at the next appointment (in 6 months) and future appointments, he should be more used to it because he would have been a few times. Good point, yes:

Desensitization (where the anxiety or emotional response to a situation/stimulus is reduced through repeated experience, or exposure to that situation/stimulus) 

and habituation (reduced response from repeated exposure to the “thing”  and over time because it doesn’t have the same impact any more)!

So the brief appointment wasn’t in vain.

Anyway, what do guidelines say about child tooth health? The NHS says about children’s teeth:

A regular teeth-cleaning routine is essential for good dental health

Obviously… and what else?

Start brushing your baby’s teeth with fluoride toothpaste as soon as the first milk tooth breaks through… It’s important to use a fluoride paste as this helps prevent and control tooth decay

 

Below the age of three years, children should use just a smear of toothpaste.

 

And further information found here says:

 

Your child’s teeth should be brushed twice a day: last thing at night before bed and at least one other time

 

The amount of toothpaste used depends on your child’s age. For children under three years, use a smear or thin film of toothpaste that covers less than three-quarters of the brush.

 

Don’t let your child eat or lick toothpaste from the tube.

 

All children should use fluoride toothpaste…Children under three should use toothpaste containing no less than 1,000 ppm fluoride.

 

What about the dentist:

Taking your child to the dentist

Take your child to the dentist when the first milk teeth appear. This is so they become familiar with the environment and get to know the dentist. The dentist can help prevent decay and identify any oral health problems at an early stage. Just opening up the child’s mouth for the dentist to take a look is useful practise for when they could benefit from future preventative care.

 

When you visit the dentist, be positive about it and make the trip fun. This will stop your child worrying about future visits.

 

Take your child for regular dental check-ups as advised by the dentist. NHS dental care for children is free.

Oh good, so this taps into the earlier points about gradually exposing the child to the dentist and dental environment so that it becomes normal and familiar. Also, associating the trip with something fun and exciting sounds like a good idea, so that it doesn’t seem like a big, scary thing.

 

…Next appointment, 6 months!

DIY Montessori Inspired Object Permanence Box for baby & infants

Date: January 3, 2015
Author: Emm
Categories: Age: 6-9 months, Age: 9-12 months, Age: General Baby/Infant, Behavioural & Cognitive-Behavioural Psychology, Development, Montessori, Motor Skills, Play & Activity
Comments: 3 Replies

 

Do-it-yourself Object Permanence Box for infants: Inspired by Montessori materials.

  • This is practically free to make. You just need some cardboard, glue or tape, and a ball

 

DIY Montessori inspired object permanence box for baby/infants. Costs practically nothing to make. baby-brain.co.uk

 

DIY Montessori inspired object permanence box for baby/infants. Costs practically nothing to make, so many learning benefits. baby-brain.co.uk

How we made the box

Inspired by Montessori materials and activities, I’d always wanted an object permanence box but didn’t really want to spend £40 or so on the wooden box. So – I decided to try and make one out of cardboard and old boxes and it seemed to work. My Little Lovely (LL) really enjoys using it, putting the ball and other items in the top, exploring the box and seeing what happens if he puts the ball in the other hole.
Aims of the object permanence box: The infant has to drop a ball into the hole in the top of the box. The ball is then not visible for a moment but rolls out of the box onto the tray. The child therefore experiences a lesson in “object permanence” because they see that the ball didn’t just disappear out of existence – even though they couldn’t see it for a second, it still exists
Other learning benefits of the box: encourages curiosity, cause and effect, hand movements and fine motor skills (dropping the ball into the hole, etc), achieving a goal independently with repeated practice.
When to use the box: From when babies are old enough to sit up without support.
Here’s a short video of what the real deal looks like, as used by a 9 month old, and another of a child at nearly 1 year

 

Psychology & Object Permanence: Object Permanence is an awareness that children develop where “out of sight” does not mean “out of mind”. Initially, when something is removed from view of the baby then from their understanding it ceases to exist – they can’t see it, so it doesn’t exist. Understanding that something exists even when you can’t see it is an important developmental stage, according to the Stages of Cognitive Development as posed by Jean Piaget, an eminent and Swiss psychologist. It is posed as a stage in development because it requires the child to form a “schema”, or mental representation of the object. Infants develop this skill by the end of the “sensorimotor stage”. It was thought to develop around 8-12 months, although there is research to suggest it can develop earlier, and the psychological research does not seem to agree on exact age.

 

How to make the box:

DIY Montessori inspired object permanence box for baby/infants. Costs practically nothing to make, so many learning benefits. baby-brain.co.uk

1: I found a long cardboard box and cut some of the sides down so that I had a long, not too deep tray for the ball to run into and be contained.
2: An old tea box looked good for the little box to house the ball. I cut a hole in the top and on the front for the ball to run out of.
3: The ball needed a bit of help rolling out of the tea box and onto the cardboard tray so I made a little ramp (otherwise the ball just sat in the box after being dropped in and didn’t roll out). This was actually part of the lid from the tea box and was already slanted so I didn’t need to do much to it.
I then slotted the ramp into the tea box and glued the tea box onto the long box. You might be able to see in picture 2, there are some little flaps on the bottom of the box on each side. This was quite helpful and I put the glue on these flaps then pressed it down onto the long cardboard tray.

 

DIY Montessori inspired object permanence box for baby/infants. Costs practically nothing to make, so many learning benefits. baby-brain.co.uk
4: I realised that the box was looking a bit DIY so for some reason I decided to make it look more hideous by adding some wrapping paper.
5: et voilà – here is the finished box (not particularly Montessori style with the wrapping paper)

 

  • If you would like to make your box look more hideous with wrapping paper like I did, I would not recommend anything too busy like the one I used. Maybe just some plain, nice calming colours?
  • If I made it again I would also probably find a slightly bigger box for the ball to drop into. The tea box was ok but the ball rolled out of it pretty quickly, so maybe something a bit bigger might have held the ball out of sight for slightly longer. The tray is also slightly long, but I was using materials just hanging around the house that were waiting to go for recycling so I had to make do with what was available.

 

How to use the box with baby: 

I quote from a Montessori site:

Presentation of the Montessori Object Permanence Box

1. Put the work mat in place and put the object permanence box on the work mat so it will be in front of the child. Encourage the child to help.

2. Sit facing the child with the work mat between you.

3. Name the box and the ball: “This is the box. This is the ball.”

4. Slowly and deliberately place the ball in the hole.

5. When the ball rolls to a stop in the tray, smile and pick it up.

6. Repeat the action.

7. Invite the child to place the ball in the hole.

8. Once the child begins putting the ball in the hole, quietly move aside and allow her to work undisturbed.

9. When finished, invite the child to put the materials away on a low shelf so she may work with them again when she wishes.

 

And here we are experiencing the box:

(age 12 months)

DIY Montessori inspired object permanence box for baby/infants. Costs practically nothing to make, so many learning benefits. baby-brain.co.uk

Baby using the object permanence box

 

Apologies to Montessori enthusiasts – I know that you value natural materials like wood, but i’m not a carpenter and couldn’t make a box out of wood. I also know that adding wrapping paper doesn’t make it look too natural. But, hopefully I’ve captured the essence of the box, the principles and learning benefits for the child, and made an accessible and cheap alternative that can be put together easily at home.

Simple colour match activity idea for baby and toddler

Date: November 1, 2014
Author: Emm
Categories: Age: 9-12 months, Age: General Baby/Infant, Behavioural & Cognitive-Behavioural Psychology, Development, Motor Skills, Play & Activity
Comments: Leave a reply

Simple colour match activity idea for baby and toddler

A quick & easy colour match activity to try with baby and toddler, use existing items around the house. baby-brain.co.uk

Colour match activity idea: Easy and quick to set up

I Just set this up for the Little Lovely to play with tomorrow morning.

At 10.5 months he’s probably a bit young for colour matching (I think, but let’s see what he does tomorrow), but we will:

  • talk about the colours

  • and I’ll demonstrate (model) sorting them

I think these will be important aspects if the kid is a bit too young to sort the colours themselves → Learning through observation (vicarious learning), and also the social and fun aspects of doing it this way will be important.

Other things he might get from this activity: Motor skill development, sensory play (items have different textures and functions), exploration, learning about colours.

 

Materials:

I used things that I already had about the house for this. The items are:

Blue: wooden round shapes, dolphin bath toy, a large lid from fridge pack of baked beans, linky loop, and a small plastic baby food pot

Green: crab bath toy, rattle, linky loop, and gum massager stick for teething

Pink: ball, wooden triangle shape, measuring spoon, and a roller with Velcro texture.

They are sitting on two pieces of LL’s clothing (blue vest and green jumper), and one of his toys (child safe mirror turned face down).

 

….. Hope he enjoys it!

Tooth for the price of one – again! (teething, biting & breastfeeding)

Date: June 15, 2014
Author: Emm
Categories: Age: 3-6 months, Age: 6-9 months, Behavioural & Cognitive-Behavioural Psychology, Development, Feeding, Teething
Comments: Leave a reply
Biting, teething and breastfeeding

Is there just one upper central incisor coming in here?

So I thought I could see a new tooth coming in on the top, an “upper central incisor”. This would be the next tooth to come in after his lower front teeth according to tooth order information. However, yesterday it looked like, again, he decided to be efficient and grow two at the same time. And yes, indeed there is another upper central incisor coming in. So now we will have a scary mouth of upper and lower front teeth. Scary for me as I am the one feeding him. He has bitten me twice; I had already thought in advance what I was going to do if he bit me. I decided to yell and express that it hurt as soon as he bit me, to take him off, look at him and say “biting hurts mummy” – see this post on behavioural psychology and explanation of reinforcement and punishers for why – in a nutshell, I wanted to give immediate feedback and a consequence to the biting, and to show that it had an impact. He cried and I cuddled him.

Here’s a brief recap on punishment and reinforcement: 

  • “Punishment” doesn’t necessarily mean there is a harmful or dangerous consequence, it’s a process where a consequence immediately follows a behaviour which decreases the future likelihood of that behaviour occurring. Positive punishment is where a negative consequence is put in place after the behaviour, like sending child to “time out” or telling them off, and negative punishment where a good thing or desired outcome is removed after the behaviour occurs, such as removing cake/sweets. 
  • Reinforcement is where behaviour increases. Positive reinforcement is where a behaviour increases because  it’s followed by a positive/motivating consequence. Negative reinforcement is where behaviour increases because a negative consequence is removed, such as a kid does his chores (behaviour) to avoid being nagged to do it (negative).

So I suppose expressing my discomfort would be a positive punisher? I don’t know if it was the “right” thing to do but I don’t want to be bitten and in fear at every feed. It seemed to work and there was no biting again for a few weeks, then he bit slightly a few days ago, so I did the same thing. I don’t know if that was because he had a new tooth coming in and he was experimenting, or what.

nope, I decided to give you BOTH upper central incisors at the same time

nope, I decided to give you BOTH upper central incisors at the same time

Also, the Little Lovely (LL) appears to be teething a bit earlier than average; first teeth might not come in until between 5 and 7 months, according to this page on teething from the NHS, and upper central incisors at 6 to 8 months. LL was about 4.5 months when his first teeth came in so maybe his younger age impacts on biting and feeding issues? I don’t really know, I’m just thinking out loud.

What I noticed each time, however, is that he was not really eating and had probably finished. It feels like sometimes, toward the end of the feed he is just “mucking around” a bit.  I can tell this by playing with his hand or kissing on his arm. If he has finished eating then he will giggle a bit and smile – if he is proper eating and seriously concentrating on that, he does not react to this playing so I leave him to get on with eating. So, maybe he was just experimenting with his new teeth. I will need to retrospectively complete a behavioural analysis on the situation if he does it again! Indeed, from from having a quick search online babies are more likely to bite if they are full, and teething can also impact on biting. So looking at contextual factors in considering why baby bites might be helpful because LL was teething when he bit a few days ago because the other top front tooth was probably about to break through.

Here are some “tips to reduce and eliminate biting” from La Leche League (LLL). In summary, they write:

  • it’s physically impossible for baby to bite when latched on correctly and nursing actively. this is because baby needs to stop sucking in order to bite – so this supports my observation that his biting came at the end of the feed when he was “mucking about” and not actually eating as actively as he does at the start of a feed

  •  So, as a first “hint” of when your baby is about to bite, try and watch for a moment–usually after the initial hunger has been satisfied–when your nipple slips forward in your baby’s mouth. Often the tension in your baby’s jaw will change just before this happens.

  • when you notice this “change”, you can release the suction by placing a finger into the corner of baby’s mouth and take him off, keeping your finger in his mouth to protect the nipple. Pulling baby off might seem like an automatic response to being bitten, but it will be less painful if you release the suction!
  •  positioning may be relevant: pull baby in closer. If he begins to position himself away from the nipple, “be alert for a possible bite”. Great

 

See here for further information from LLL on “if your baby bites”, an interesting page that offers more details to the above points on what to do if baby bites, factors that might contribute to biting, positioning matters, preventing biting  and gaining perspective. The contributing factors section is interesting; it’s helpful to think about what is contributing to the biting when attempting to address it. For example, the page writes that colds (lack of clear airway could interfere with suckling correctly) teething and asking for attention can be contributing factors. Responses to and attempts to address biting might be different depending on different contributing factors.

 

 

 

 

 

The Sleep Lady

Date: May 29, 2014
Author: Emm
Categories: Age: 12-18 months, Age: 3-6 months, Age: 6-9 months, Age: General Baby/Infant, Behavioural & Cognitive-Behavioural Psychology, Routines & Schedules, Sleep
Comments: 3 Replies

Baby sleep tips and issues, psychological perspectives and do you want to Wait It Out or Cry It Out? baby-brain.co.uk

 

sleeping cot

So yesterday the Little Lovely and I went to a baby talk thingy about sleep (aged 5 months)

We’d actually been to it before, a couple of months ago, and the session was being run again by a sleep expert woman that you can hire the services of for quite a lot of money. She kept it quite generic as there were a lot of mothers there with various issues but some common aspects among us, mostly being that baby was not sleeping as long as we’d like them to (of course) or issues with getting baby off to sleep. It was very interesting to go, normalised the sleep issues because, as we discussed, even if you have some “friend” or mother you come across that states that their child sleeps for 12 hours at night uninterrupted, that is the exception and not the norm. I’ll add though that the babies here were probably all under 8-10 months old.
It also made me think that maybe LL’s sleeping isn’t that bad afterall! Sure, i’m up about 3 times a night to feed him and I get about 2-3 hour stretches of sleep, but some of the mothers there were up 7 times a night and one spoke about how her baby scratches himself at night and only falls asleep by scratching himself. She had to put gloves on him. The sleep lady thought that the touching and scratching was something he did to stimulate himself and help get himself to sleep and suggested a comforter with tags or something tactile on it. Interesting situation; wish we’d spoken about it more but unfortunately someone with a louder voice took up a lot of the time (as is often the case in groups) about how her child sleeps from 8 until 5am, but she couldn’t get him to sleep any later than 5am and was tired of getting up so early. Someone eventually commented, when the group couldn’t find any satisfactory solution, maybe she should be happy that her child is sleeping for 9 hours at a time because most of us are not. Harsh, but true especially when speaking to a group of sleep deprived mothers who have been deprived for about half a year or more.

 

Other issues we talked about:
    • sleep associations
    • independent comforters – for example using a comforter, blanket, something that is independent from you and is not the breast, being rocked by you etc, so that baby can use this to feel secure and self sooth and you do not need to be there every time he falls sleeps. We tried this with LL but it never really took off. I bought a nice comforter blanket and slept with it for a few nights (as the sleep lady recommended, to get your smell on it) and got it out when feeding LL (the sleep lady recommended actually putting it between you and baby when feeding) but he wasn’t interested. Another thing I could have done but didn’t would be to play with it with LL and associate it with fun and get him more used to it.
    • putting baby down when sleeping/drowsy – using whatever method you use for baby to get sleepy e.g. rocking, cuddles, etc, but not using these to the point where he is actually asleep and therefore teaching baby the skill of falling asleep independently (much easier said than done, of course)
    • a good bedtime routine, nap routines including use of certain words such as “sleeping time now” or any other word cues. Basically, weaving some cues into the routine so that baby can start to recognise it’s nearly sleep time by using words, song, actions like reading a book
    • something called “wake to sleep” – i’ve not heard of this, I need to look into it more (note to self – look into this)
    • shaping naps with baby after 5 months of age – this was good to hear because i was thinking that we need to start getting a good nap routine and schedule in place and LL is nearly 5 and half months.
    • start with one nap at a time, focus on it and then build on it – building on the above point, to focus on one nap and work on that to begin with – also good to hear because I have been focussing on the morning nap with LL and making sure we 1) do one! 2) he is in his cot 3) he falls asleep in his cot which he mostly does although sometimes I need to go into the bedroom and shush/pat or pick him up and comfort him a few times. We were previously doing morning naps in the buggy because LL only fell asleep by being pushed back and forth in it.

 

We also spoke about whether you should let your baby cry at night and there were mixed views. There was the view that “happy parent makes happy baby” and so if baby cries for a bit during “sleep training” but then sleeps better as the outcome then everyone in the family benefits. I know that this could be a contentious issue as some are very firmly no cry, and others are not. I have also come across the view that leaving baby to “cry it out” and “controlled crying” results in an eventual reduction of crying, a quieter baby and better sleeping because it actually develops learned helplessness – the baby stops crying and sleeps because they have learnt that nothing they do in the situation can help and they have no control. They have learnt this because the times that they did cry, they were left to cry, or were comforted but didn’t receieve a feed or get picked up or whatever else they were expecting. Therefore, they are helpless and give up, rather than the view that the sleep training intervention resulted in baby sleeping peacefully because they “learnt” to sleep, learnt that it is night time and therefore they should be tired and sleep.

 

Ψ here’s a nice short video and further info on the traditional meaning of learned helplessness, observations/research that led to the development of the term (Seligman), and it’s application to mental health (attributions)

 

Erm, not sure about this myself, seems bit extreme, I mean, we’re talking about behavioural aspects here. Ok, say there is a behaviour going on that is not really very nice and leads to some problems for another person, say for example, your child goes around hitting another child and screaming in their face. Most people would address this and implement some kind of behavioural strategy, maybe some kind of reinforcement or positive punishment such as telling the child off, removing a reward (negative punishment) etc.

 

Ψ Here’s a good page that explains positive/negative reinforcement and punishers – for example, they explain that “punishment” doesn’t necessarily mean there is a harmful or dangerous consequence, it’s a process where a consequence immediately follows a behaviour which decreases the future likelihood of that behaviour occurring. Positive punishment is where a negative consequence is put in place after the behaviour, like sending child to “time out” or telling them off, and negative punishment where a good thing or desired outcome is removed after the behaviour occurs, such as removing cake/sweets/ice cream because the child was “naughty”. Reinforcement is where behaviour increases. Positive reinforcement is where a behaviour increases because  it’s followed by a positive/motivating consequence such as praise, reward, like giving a kid money (positive) for doing chores (the behaviour). Negative reinforcement is where behaviour increases because a negative consequence is removed, such as a kid does his chores (behaviour) to avoid being nagged to do it (negative).

 

Ψ punishers = want to decrease frequency/likelihood of a behaviour

Ψ reinforcers = want to increase frequency/likelihood of a behaviour

 

Anyway, what was my point~? I think it was that you might implement some kind of behavioural strategy or consequence for some behaviours but would we call the desired outcome, i.e. the kid stops screaming at and hitting the other child, an example of learned helplessness? Why implement the strategy in the first place? Well because not many people in the situation are benefiting – the other child isn’t, the parent isn’t, and what’s the child’s motivation or concern that is leading to him screaming and hitting? Because parents are “training” or “guiding” their child in something, be it sleep or other behaviours, why must the outcome be labelled learned helplessness? Each family and parent is different and has their own motivation and justification for what they do, and if by leaving their child to cry for a few minutes at a time while periodically comforting them (or not, depending on the parent), so that the outcome is that they can sleep and therefore better parent their children and cope with the day, then so be it.
I fell asleep

I fell asleep

And so speaking of which, I’m also going to start working on some of these night time feeds because i’m not sure how good it is for either of us to be waking up every few hours. I might start with one and see what happens. Did I mention that I’ve been sleep deprived for almost half a year?

 

 

 

 

Please note: there are of course many other views and approaches to the change to one’s sleeping patterns that comes with children. See, for example, this post on something called “wait it out” (rather than cry it out, I assume).
A quote from the article (I especially like point 1 about sleep being developmental, not behavioural):

WIO or the “Wait it Out” Method of sleep training is a method with a few core beliefs:

1- Independent sleep is developmental not behavioral. 
2- Needing comfort and closeness is an instinct not a preference.
3- Cries are communication not manipulation.
4- Babies can slowly and gently learn to be comfortable with independent sleep as they are developmentally ready.
5- The path each baby will take to independent sleep is unique.
6- The progression to independent sleep does not always feel like forward momentum.

 

Further relevant links:

 

 

Day Time Schedules

Date: April 29, 2014
Author: Emm
Categories: Age: 3-6 months, Behavioural & Cognitive-Behavioural Psychology, Mental Health, Routines & Schedules
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Thinking more about him sleeping through the night, I was thinking about schedules. ???????????????????????????????

I’m attempting a better day time schedule (maybe this will positively impact on night time?). So far we don’t really have one. This is terrible I know because in my work I am all about behavioural interventions and working with people to log their activities and create meaningful activities and some structure to their day. In my depression related work with adults this can be fundamental and people often see an increase in mood with an increase in meaningful activities, good self care and better sleep at night. At the moment with LL we just do what I think he wants to do when he wants to do it. It’s probably an extension of the feeding and sleeping on demand that was present from birth. But now I’m wondering if the lack of structure and routine is just not very containing or predictable for him, or for me. Naps and feeds then get thrown off and can occur at any time. He doesn’t know what to expect and neither do I.

In another attempt to break the eat-sleep association, I’m trying to not feed before naps and instead to do a feed, wake (inc. play/activities/baby classes etc) and then sleep kind of structure. I just need to work out how long each cycle should be. Some say 3, some say 4 hours at this stage (e.g. Baby Whisperer; LL is 4.5 months). The eat-sleep association just kind of arose because it was difficult to get LL off to sleep initially and that seemed to work. Rocking him while singing row your boat also seemed to work for day time naps and although I knew that in the long term these methods might not be great because he was reliant on my rocking or feeding, I didn’t mind because at least he was getting some sleep and not cyring about being tired. I thought – well I’ll just have to make changes to any habits later on because at this point (first few weeks/months) any sleep is better than no sleep, and I don’t care how we achieve it! And the longer the sleep, the better.

Ok so plan for next few weeks is to start more of a day time routine! Consistency and predictability is really important.

When will he sleep through the night?

Date: April 27, 2014
Author: Emm
Categories: Age: 3-6 months, Behavioural & Cognitive-Behavioural Psychology, Routines & Schedules, Sleep
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So we are still getting up a few times a night for feeds.

The Little Lovely (LL) seems to wake up around 1am, 3:30/4am and then about 6:30am. Apparently 6:30am is classed as morning and doesn’t count as a night awakening. Well it does in my book because it’s still the middle of the night and too early for me. He goes to bed around 8pm so can now go a good 5 hours before waking which is great compared to the earlier months and weeks when I was getting up every 2 hours to feed him and it was horrible. I think I must have adapted to disturbed sleep and little sleep. I wonder if my sleep cycle has adapted so that the times LL wakes up actually coincide with the end of a sleep cycle? I have no idea if that’s possible.

What’s the research on this? (note to self – look into this)

So now I’m wondering if he should be sleeping without so many feeds and if I should be doing something about this – or if he is still too young. I don’t mind the first feed at 1am because he has had a good stretch of sleep. But is the next feed necessary? Should we just put up with it until he’s weaned or should we spend a few screamy nights of breaking the eat/sleep association)? Yaaay says LL’s father, to the latter idea. But what if he is genuinely hungry?

A quick look at the internet says that LL might be a “habitual waker” because he tends to wake at the same time every night. Apparently if he was going through a growth spurt and needed the food he would be waking at random times. We briefly attempted not feeding him during one waking the other night and all that happened was he cried at us and refused to be soothed or settled by cuddles, rocking or any other soothing and only calmed once he was fed.

Maybe I can try a briefer feed and slowly cut down on the length/time of feed to change the association between eating and sleeping  (I have to suckle in order to fall asleep, otherwise I can’t do it alone).Although I’m not sure if a graded approach will work because I would still be feeding him to sleep, plus I’m very tired at 4am and might dose off and lose track of how long it’s been or it might work somewhat but take some time. And dosing off while nursing (both of us) is probably contributing to the issue.

I’ve found this:

PANTLEY’S GENTLE REMOVAL PLAN (See here)

More on how Pantley developed The No-Cry Sleep Solution and her research methods

from what I understand, this involves:

  • Feeding baby when awake but rather than letting him fall asleep during the feed and whilst sucking, wait until he is relaxed and sleepy, then remove the breast/bottle just before falling asleep.
  • If baby starts to look for the breast/bottle and tries to continue sucking then try to hold his mouth closed gently by putting a finger under his chin or some light pressure on the chin just below his lips (hmm, sounds easier said than done). You can rock the baby or say comforting words while doing this.
  • If this doesn’t go down well then give the bottle/breast again and repeat the process until he falls asleep without sucking.
  • When removing the breast/bottle, do this for about 10-60 seconds and count while you do this
  • Repeat each night until baby can fall asleep on own and does not frequently wake at night.
  • Work on this technique at bedtime, in particular the initial falling asleep as baby will probably want to fall asleep the same way for the rest of the night following any further awakenings.
  • Once night time use of this method is achieved then it can also be used for naps.
  • It could take several days or longer to break the association but you should eventually see a reduction in night awakenings

…… well we’ll see how well that goes down!

(see Pantley’s book if you are interested in more – I haven’t read it, just found the information above from general sleep and baby forum reading online)

The other option is just to not nurse LL to sleep in the first place and to break the association, or develop a new association there. We should try reading a book or singing a lullaby or something immediately before sleep.

  • Rather than feeding him in the bedroom right before he falls asleep maybe I’ll feed him in the living room with a dim light – then take him into the bedroom for a story or another quiet activity immediately prior to sleep.