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Caring for the High Maintenance Child
By Kate Andersen.

Sleep and Bed-Time Problems. July, 2017.
Dear Kate:
My 11 month old "spirited" girl has been ill with an ear and upper respiratory infection for about a month now......
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Issue Theme: Sleep and Bed-Time Problems.

Resisting Going to Bed

Many youngsters resist going to bed. This is not surprising. All the things they value most - parental attention, play and other sources of fun - suddenly disappear at bed time. An episode on a television sitcom illustrated this point very well. A scene showed the fantasies of a little girl who was the youngest child of a large and active family. While lying in bed, in her mind she pictured her parents and older siblings holding parties and playing wonderful games as soon as she was tucked into bed and her bedroom door closed. This must be the way many very emotionally healthy children feel. Their lives are full of good things and at bed-time those good things stop. My point is that resisting going to bed is not always a sign of an underlying emotional problem. Resisting going to bed at night should be distinguished from having trouble falling asleep, although the two problems can occur together.

However, emotional problems can play a role in bed-time resistance. Insecure children understandably feel suddenly more anxious as soon as they are alone in bed. The methods used to keep worries at bay during the day-time are often not available any more. As well, developmental fears of the dark or of separation will obviously intensify when a child is put to bed alone and in the dark. These fears can lead to calling in the parent and the child may work hard to prolong the visit and fight any attempt on the part of the parent to leave, expressing worries that there are boogie men in the closet or that they heard strange noises.

The most helpful approach to night-time fears is to address them during the day-time by increasing children's feelings of security. Developing complicated reassurance rituals at bed-time often intensifies the fears as the involvement of adults in searching under the bed for monsters can cause children to wonder if there must be some reality to their concerns. When addressing children's anxieties during the day-time, parents and helpers need to explore the basis for the fears or worries, such as overhearing parents arguing or the loss of a playmate when a family moves away. Sadness about real but not ongoing events can often be sorted out by working through them with blackboard stories, books or puppets. These real feelings need to be acknowledged and not seen as problematic behavior. Even after children have come to terms with the loss of a pet, for example, tears can return when memories are evoked. This is a natural and normal form of grieving and in itself a sign of healthy emotional development.

Other fears and worries require that adults change their behavior and not subject children to scenes or words which will foster anxiety. This includes frightening television shows which do not have to be violent to terrify young children. Helpers can play a very helpful role in pointing out to parents that young children including babies, even if they are too young to understand what is going on, are profoundly affected by what they hear and see.

When temperament-environment stress is present, anxiety at night may represent a secondary emotional disturbance as a result of the conflictual interactions. Some parents do not realize that the child whom they perceive as 'feisty' and 'tough' is often quite fearful under the negative and oppositional exterior. The child may speak of monsters or strange noises but in fact be symbolically expressing feelings of being unloved or unacceptable. Clearly the best remedy for anxiety with this basis is to improve the parent-child (or caregiver-child) fit.

 
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