How can you tell me where it hurts? Part II
My Bratty was in the dental ward in the hospital yesterday, having what we hope will be the last 2 extractions under General Anaesthetic that she has to go through.
Due to problems with her babyteeth, her second teeth have come in a bit crowded and they had to make space.
But the Dental Surgeon said that all the others were perfect and we were doing a great job.
That was not the case 5 years ago.
On that visit she had 7 extractions under G.A. and we had obviously not done "a good job."
Poor Bratty had a bad diet, oral defensiveness and decay in her baby teeth that had obviously been painful.
But at the time I didn't know. When it was discovered and I made the necessary changes to her oral hygiene routine and lifestyle - (I was the worlds least popular mummy at the time) - I swore I would find a way to teach her to: "tell me where it hurts"
This is really hard because you are teaching someone to Comment on something Abstract.
Commenting is not naturally rewarding - you have to structure it with tangible rewards in order to make it rewarding.
You say "I see dog" And child thinks "Who the hell cares?"
But if you get a picture book and teach them to say:
"I see dog" then - "here have a chocolate button."
- you will eventually get the child saying:
"I see a cat, elephant, starfish, look there's an aeroplane"
because you have paired that purely social "sharing" with a tangible reward.
Then pair the tangible reward with praise - and eventually you can just praise them for sharing. (and ditch the chocolate buttons)
All the above works just as well with picture communication. You set up the opportunity, you prompt, reward, praise and when it is repeated, reward and praise again.
So for "feelings" you create your "talking about pain cards" (or in my case buy them on ebay)
and then wait for a natural opportunity, such as a fall in the playground or a bumped elbow, to prompt the child to say where it hurts because you can actually see where it hurts.
It isn't an abstract concept as the child is actually feeling the pain as you show them.
The problem is of course, that the "pain cards" are probably back home in the cupboard when they fall off the swings and graze their knee. Leaving them in the dirt crying while you go get them is not exactly ethical, or caring.
And this is where Grace App on iPhone comes in.
While you may have left the picture cards back in the press at home. You always have your phone when you are out - so the final version of Grace App includes a section called "My Body"
When the pain happens, Grab the phone and select "My Body" Hand over Hand so the child is selecting the category picture with you
Then prompt them to choose "Sore"and "knee"
And as I said in Part I, give them a lot of care and attention around that poor sore knee. Saying "Sore Knee" and pointing to the pictures and the actual knee, a lot.
In a separate exercise; (when they are no longer in pain) you teach all the other body parts using flashcards or standard picture exchange requests.
How do you request a body part? Try using our friend Mr Potato Head as a 3D teaching tool.
Set up a mirror and the potato man and keep hold of the body parts. They can request "I want nose" and "I want eyes" using the phone.
At the same time do a little "show me your eyes" and prompt a nice point at eyes looking in the mirror together. So it is real, not abstract.
They will associate the picture of "eyes" on the phone with their eyes.
We also play a drawing game with Bratty. She requests a Teletubby or Muppet using her words and a colored crayon or marker. I draw the outline, then she requests "circle face", eyes, mouth, ears, aerial and "square tummy". Okay, people don't have aerials, but you get the rest of the idea. The important thing is that the game is based on their favourite character. Not some boring picture of a face.
You could also print off and make 6 x 8 flashcards (ugh) and do the standard; Point to, Give me, Show me, What's this? direct teaching. (or find someone else to do that bit!)
And from that, practice naming their real body parts with tickle or massage games, looking in a mirror together, or putting shaving cream on in the bath. Keep it fun and look for lots of opportunities to repeat the game during the day. From that you will hopefully create good body awareness, and recognition that they can then generalise into understanding. And when they have a hurt you don't know about - tell you.
Grace App was developed by Grace, Me and Steve Troughton-Smith (the Tech Wizard) with the support of O2. Mary Moroney did the original drawings we use.
If you want to make a set of those cards: email me and I will send you the images.*
But consider this a copyright, mmokay?