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1) Dear Dr. Marwa, my son is 5 years old and I was trapped in a very embarrassing yet funny situation that I wasn’t able to handle. A few days ago I caught him touching his private parts and then he asked me: "Mommy why is it sometimes hard and stands up?" I totally freaked and just yelled at him: "Honey just don’t you touch it!". This situation confronted me with a fact I had never considered on how to handle these kinds of questions? What should I do?
Some adults are surprised to learn that it is normal for young children to have sexual feelings. These are not adult sexual activities, but signs of normal interest. Most begin exploring their own bodies from late infancy. Sexual curiosity is normal as well for preschoolers and kindergartners. Their discovery of touching themselves is a natural part of growing up. This behaviour in a young child is rarely a cause for alarm. As to what to do about it, make sure your child has regular opportunities to express his thoughts to a parent, explain to him that what he feels and senses is normal. Explain to him calmly that this is his private part and nobody should touch it or see it unless it is mommy or daddy when it hurts and only his own paediatrician if there is any kind of problem. You should then keep him busy with mental and physical activities that he enjoys.
Toilet training a child takes a lot of patience, time and understanding. Most children do not become fully toilet trained until they reach the age of 4. Your daughter appears to have what is called primary nocturnal enuresis, this means that she is dry during the day but has not yet achieved dryness at night. This is a normal behaviour at that age, and parents sometimes compare their child to others especially in kindergarten or even to their other siblings at a similar age which adds more pressure to the child. All she needs is just few more months.
On the other hand secondary nocturnal enuresis (when the child already achieved dryness at night for 3-6 months then start wetting himself again), this is an alarming issue as it might indicate an emotional or behavioural problem e.g. a new baby arrival, and other more serious problems, this is when you should seek expert advice if u can’t handle it.
Your young child is busy learning many things about his world. He is eager to take control; he wants to be independent and will try all the skills he has. He wants to make his own choices. Controlling his temper may be one of the most difficult lessons for him to learn. Before being frustrated and confused about what to do, you have to understand why toddlers get these tantrums, it is a way for your child to let off steam when he is upset especially when he does not fully understand what you are asking for, or on the other hand when you are not understanding what he is saying, he may be tired, anxious or uncomfortable.
Tantrums are a way your child tests your rules and limits, most of the time you will know as a parent when a tantrum is coming, so to help prevent them you may in advance:
1. Keep a daily routine, and set your child reasonable limits.
2. Encourage your child to use words and always try to give
him different choices.
3. Avoid long outings or visits and situations that will frustrate
4. Always be prepared with healthy snacks when he gets
5. Make sure he is well rested before a long busy day.
6. Distract him from activities that may lead to a tantrum.
7. Last but no least set a good example: Avoid arguing or
yelling in front of him.
If a tantrum does occur in public, do the following:
1. Distract your child by calling his attention to something else.
2. Interrupt his behaviour by touching him or by a light
If this behaviour holds on and he gets more aggressive, try to remain calm, if you become angry or shout things will only get worse, what you do is gently restrain him and remove him from the situation until he cools off and never punish or hit during the attack. When you get back he should be put in “Time Out” if he got aggressive at that time (hitting, kicking, throwing things) then talk about it and discuss other ways to deal with it next time. Do not reward your child for stopping a tantrum. Be consistent and avoid sending mixed signals.
Starting Kindergarten is a big step for many young children. The most common challenge for most kids is saying goodbye to their parents, or trouble separating; this is what we call “Separation Anxiety”. Every child separates at a different rate, in his or her own way. There is nothing weaker or stronger about one or another. Young children are understandably caught between the urge for independence and the need to be safe. You can begin by making the separation gradually, letting the child take as much time as he needs to be comfortable in the new environment. That means:
1. One parent or other adult who is very close to the child stays in the classroom until it is clear that the child is ready to try brief separations.
2. There should be no sneaking out. Make a very specific agreement when the time comes to leave the room, such as, "How about if I come back right after snack?"
3. Good-bye rituals often help at that point, such as a special hug and wave through the window.
4. Keeping something meaningful from home like a favourite blanket or teddy bear they can carry around with them all day; or even a story so the teacher can read it.
5. Give your child lots of reassurance that "Mommy’s coming back”. To reinforce the idea, you can play a little game in which something disappears from sight but your child rediscovers it, and then explain to him “just like Mommy when she went to work”.
6. The first thing you have to do to prepare your child is to prepare yourself!!!
If you apply these steps with no improvement you should seek a professional.
Sibling rivalry is a universal reality, perhaps it may help to consider the fact that your big girl is in a bind, and she doesn’t know where to go with her normal jealousy and can’t control her feelings towards her adored little brother. Try considering it from your children’s points of view, biting, hitting and other aggressive actions tell you she is feeling frightened and mad. If you help her to use words she will be able to express herself rather than act out her upset feelings.
Find about an hour a day to spend just with your older child, maybe during the toddler’s nap. In that hour, give your full attention to your big girl, joining her and allowing her to take the lead in a dramatic play. She may express some of her frustration through the drama, giving you a chance to acknowledge her feelings. Perhaps the two of you may go off to have an ice-cream or another fun spot, with her talking and you actively listening.
When you are occupied with the youngest, find tasks for the big one to do, ways for her to help you, or ways to continue with a game or activity that the little one can’t do, chores or games only for big girls.
Enrol her in a quality preschool program, where learning to share is part of their daily routine. Arrange for play dates with other 4-year-olds whenever you can.
Bedtime should be warm and loving, reading a favourite story, hugs and kisses and reminders that she is your princess.
Dr. Marwa Saeed
Kasr El Eini Hospital
Paediatrician, Child Behaviour Therapy
Child Behaviour Management (The Clarity Method)
Cognitive Behaviour Therapy Program
Development and Behavioural Paediatrics
Mohandsein/ Tel: 3024311