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Can D Responsibility Be Taught?

Discussion in 'Parents of Children with Type 1' started by DavidN, Mar 30, 2015.

  1. DavidN

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    I was watching my 11-year old son's baseball game this weekend. There is another T1D boy (John), dx a year after my son, on his team. Game ends. A mom brings cupcakes for the team to celebrate her son's birthday. My son is first in line, would have taken two if they allowed it. John is off to the side not participating. I mozy over to him and ask, "aren't you going to have a cupcake"? He says, "no, it messes up my blood sugars too much" (meanwhile John's mom is munching on a cupcake and told me he made the decision on his own). Not in a million years would my son make that call. I'm okay with the occasional cupcake, but I'd really like to see my son occasionally sacrifice a crappy food to promote his health.

    I often read of kids on this site who like John, seem responsible beyond their years, and kids like my son who have little regard for food choice consequences.

    My son is bright, but a tad ADD, and very much lives in the present. Forget to bolus? "Whatever". Pod comes off and he doesn't replace it? "Oh, I didn't think it was a big deal". You may have read about our recent sleepover debacle.

    I know D management (I:C ratios, temp basals, exercise, fatty foods etc ...) can be taught. My son knows this stuff pretty well. But can D responsibility be taught? Or at least successfully encouraged.

    Instilling him with fear of long-term consequences won't work. He can't think out beyond 24 hours. On the surface A1C rewards (iPhone 6 instead of the 4S) seem like a good idea but my gut is telling me will just cause more problems.

    We do most the D heavy lifting which I'm fine with, but he's getting older and spending more and more time away from us.

    What has worked for you in successfully encouraging D responsibility? I know this can be the $100k question for the tween/teen years, but it's starting to become an issue and I'm just thinking out loud. Any thoughts are appreciated.

    Thanks.
     
  2. jenm999

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    Wow, my takeaway is completely different. I am sad for John and worry that he might rebel at some point. If I were his parent I would have praised him for declining the cupcake but encouraged him to be part of the celebration (it's the "off to the side not participating" that caught my eye). I definitely wouldn't have shrugged an eaten a cupcake myself. Even better, I might have offered to help him think through a good way to bolus effectively for that cupcake. Or if he really does not like the way sweets make him feel I would have been prepared with an alternate treat - sugar-free popsicle or something - so he would not be left out. 11 seems young to expect this kind of self-sacrifice.
     
  3. Sarah Maddie's Mom

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    Big picture, kids mature at different ages, Some kids (like some adults) have great self-discipline be it in training for a sport or studying harder than their peers, but most don't. Most kids live in the present and cupcakes are all about "the now" '-)

    With regard to the Type 1 kid? - who knows. Maybe that kid get's a strong message from Mom and Dad that fluctuating bgs are "bad" and that he "isn't doing a good job" if they happen. Maybe he was dxd as an infant and has endured a decade of nagging behind closed doors. Maybe he really does feel crappy when high and he's one of those naturally self-disciplined kids. Maybe the cupcakes were vanilla and he only likes red velvet. Maybe he knows he's going out for pizza later and his parents will make him wait till bg is 100 before he can have any. You just don't know.

    My kid only started thinking about the impact of certain food on her bg when she was 14ish - there's nothing odd to me at all about your son's behavior and I would not impose any limits beyond what you would impose had he not developed Type 1. As long as he boluses then he's doing the age appropriate thing.
     
  4. nebby3

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    Like the PP I also thought this doesn't sound like a great situation. Either the other boy is naturally a worrier or maybe his parents have, either purposefully or inadvertently, instilled that feeling in him. I'd rather my tween eat the cupcake and enjoy themselves. There is a time to learn responsibility but I am not sure you are there yet. I know my non D 11yo boy would never ever ever turn down food. My cwd who is a 13yo girl will turn down food when she is somewhere without me cause she doesn't want to text me or figure it out on her own but not really from bg concerns. I actually try to encourage her to just guess and we'll deal with the consequences on her bg later but she is more hesitant. She is kind of a worrier too though.
     
  5. kiwikid

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    Nothing for us has worked successfully. At home with me (nagging I suppose) everything gets done, she knows how to do absolutely EVERYTHING to do with pump, carbs, insulin, Dexcom, exercise etc .. She has just started Boarding School - a necessity from where we live - and for the first 2 weeks she did NOTHING... She lied to me, the school, and the hostel about bg's, testing and bolusing... I had calls from the school about how the Dexcom was reading so much higher than her fingerpricks ( but yes it was reading correctly just not what she was making up to tell them). We had talked in a group situation with the school and she proved she knew what she was doing, and if it is for something she wants, or a bribe she can do everything properly for days on end..
    I do wonder where I've gone wrong and why she can lie so easily and successfully. And why she won't look after herself... ???
    The only thing I am thankful for is that she is absolutely loving school and now the staff are on top of things she can't get away with so much... But it is hard work for us all.
     
  6. DavidN

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    Thanks gang. I agree but sometimes lose perspective. The irony is the situation was fraught with pitfalls - adrenaline high, post game crash, post game cupcake, post game visit to Willy's (130 carb 5 hour extend) - and we kept BG under 200 and above 80. If anything, it should have been a lesson for my son in, "you can do whatever you want". Well ... something to work on.
     
  7. hawkeyegirl

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    Our sons are the same age, and I guarantee that Jack would have had THREE cupcakes, given the opportunity. ;)

    I, too, am sometimes blown away by some of the kids on this board and where they are with their D care. Jack can handle the basics, but when he's really into something, even the basics can elude him. It's frustrating, but developmentally normal and expected. We've been at this a lot longer than you, and I can tell you that progress in this area comes in fits and starts, and often when you're about ready to assume that you'll be sneaking into his honeymoon suite to check his BG that night.

    I think that when they want increased independence, clear expectations (restated OFTEN) are important. As are lowered expectations. Jack refusing a cupcake at a team celebration because of BG isn't even on my radar screen as far as expectations. :)
     
  8. LauraC

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    This is an interesting thread. It's really helpful to read what other parents do in these situations. My 5 year old daughter (non-D) is starting soccer and the coach says they will have a snack and juice box at the end of every game. That kinda stresses me out. Juice boxes are only for low treatments in our house. I'm already thinking about when my 3 year old daughter (type 1) wants to play soccer and how I will handle the situation. Maybe after an hour of running, she would need a juice box anyways. Do you let your kids have a juice box if everyone else is having one?
     
  9. Sarah Maddie's Mom

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    Oh, pity the parent who shows up with anything other than water and fruit for snack at sports practice here '-) I rarely see kids drinking juice boxes anymore so we haven't really had to confront that other than at the occasional birthday party, but in our experience once they have been treating lows with juice boxes for a while the whole "juice box as treat" thing kinda fades. And there's nothing wrong with separating "treats" from "treatments". Every family is different but we always treat lows with juice or tabs (maybe chocolate milk at night) but never candy. It's just easier for us that way and if you use juice for lows I'm sure your little soccer player will be happy to have a water. :cwds:
     
  10. StacyMM

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    My vote is that it can always be taught and encouraged...but some kids aren't interested in learning. :) I have one of each kid. My daughter is the responsible, practical, logical, thinks about consequences kid. My son is the laidback, forgetful, thinks about the future in terms of 30 seconds from now kid. Live in the same house, do the same things and have completely opposite brains. She's had longer, of course, but I think it's how they are wired more than it being an experience thing.
     
  11. BarbDwyer

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    On the original question. My son will often skip a treat or an entire meal because he does not want to fiddle with a shot and/or count the carbs. Once he decides to do a shot he would eat his weight in candy or cookies so the skipping isn't really about making a food choice. My goal/expectation is that he does the checks, bolus and does not lie about it. Right now he allows me to be involved in all that and I do all the counting/work when we are together. I share information on nutrition and choices occasionally (as I do with all my kids) and provide meals I think are good (most of the time ;) but I don't question his choices on what to eat. He'll have T1D for a life time. He has many years to figure out how food makes him feel and/or focus on getting super tight control of his numbers. His endo is fine with his current numbers. If things go to hell maybe we'll have to do something different.

    Regarding the juice. Yes you might find she needs it anyway but some juice boxes have way more carbs than others. Luke has anything the other kids are having - he just has to check first and do a bolus for it. Sometimes he thinks it is worth it, and sometimes not. He's much older (13) so probably makes a difference. I try to make sure he has a carb free drink at all times and a snack for activities as an option. Usually beef jerky.
     
  12. KatieSue

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    Mines older but she will sometimes skip something that she doesn't deem worth the aftermath. And possibly this kid had a horrible roller coaster blood sugar the last time he ate cupcakes.

    Mine is also a super picky eater but she's embarrassed to say she doesn't care for something, I can totally see her using diabetes as a polite way to get out of it.
     
  13. Mish

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    I snipped the rest of Barbs post because I really wanted to highlight this, because it really gets to the root of what you want. THIS is the responsibility that you should be looking to get your son to work on. It isn't about whether or not a child eats a cupcake or 3 or drinks juice. Whatever you decide for your family is the right thing for your family. But, what needs to be stressed is that he checks/boluses, and is honest about those results, and that you're non-judgmental about those results, whatever they are.

    If you can get your child to do this, and if you can do this, then whatever else happens will be all ok.
     
  14. Lisa - Aidan's mom

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    Great thread. My DS is 10. When he is at home, he will check his BG and tell me his # and that he is having a cookie, yogurt, whatever. 99% of the time he will not give his injection and I will give it to him.
    If there are friends around....baseball, party, playing in the backyard, etc., he always forgets he has diabetes! There was a drop off party that was waaaay longer than I expected, about 4-5 hours. He conveniently let Dexcom buzz away in his pocket and Lord knows what he consumed (pizza, chips, juice, cupcakes). It's the first time I ever saw "HI" on the meter. It took HOURS and countless corrections to get him down.
    I wish he would take care of himself better!
     
  15. quiltinmom

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    I guess it all depends on the why. If he just doesn't like cupcakes enough to deal with the bg's after, great. Some kids just don't like sweet things that much. Not many, but some. If he made the choice because of fear, I am sad for him to feel like he can't participate in post-game treats. In short, if he wanted that cupcake, then I am sad for him, but if he didn't want it that much, I'm fine with it. On the other hand, for a kid to pass up a treat that he wanted, for the benefit of his health, that kind of discipline can be admired by us all! :)

    I approach it this way. He is 13, so food is a big deal. I talk to him about someday, when he may decide not to eat certain things because of what it does to him, or how it makes him feel (cgm would be most enlightening, I think). But that is a choice I want to let him make. I also try to teach all of my kids good eating habits (it feels like little success at this point) and still let them have desserts sometimes, but not every day. I try not to force him to do d care things, and if he acts a little rebellious, he almost always makes the right choice if I walk away and let him decide what he will do. If he would skip testing or bolusing if I said that, I wouldn't approach it this way.

    My cwd is the responsible type, logical, etc. my second son is lore like the ones unable to think more than 30 seconds into the future. I can only cringe when I think what d care would be like with him.

    But as to your question, responsibility is already being taught, but it also has to be chosen. Also sometimes the results of not following mom and dad's advice need to be felt (I.e. Sometimes letting them make the wrong choice and have the consequences is a better teacher than making them do the right thing. Not always, but sometimes). Depends on the kid as to how and when this happens. They need nudging in the right direction, but if you push too hard they push back.

    I'm going to be following this thread. I'm interested in what those with grown cwd's have to say.
     
  16. mom2ejca

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    Even my kid who is super responsible wouldn't have made that call. She would have figured out a way to have the cupcake regardless of the bg situation... too high, wait a bit to eat it or overbolus for the cupcake and set an alarm to eat some more later. Or just eat the cupcake and make sure to look at Dexcom in a couple hrs to fix it.
     
  17. susanlindstrom16

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    The juice box thing is a pet peeve of mine bc we also only use them for lows. Luckily my daughter loves ice cold water so if there are also water bottles in the cooler at the party or wherever we are, I can usually steer her in that direction pretty easily. However, if all the kids are having one and its clear she will feel left out, I'll let her have one. I just hate when its those 24g juices!

    As far as the original issue, my daughter is only 7 so i don't expect really anything from her- she tells me when she wants to do her own check or bolus herself. She is basically a cupcake queen and would be right there with your son asking for a second cupcake!
     
  18. mamattorney

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    Only my non-D kids play rec soccer but the drink of choice for after the game is that low cal Gatorade G2. Drives me nuts because they are 12 oz and my kids drink about 4 oz and then leave 3/4 full G2 bottles in the back of the van until I find them the next week. As if playing half of a 40 minute soccer match really requires such intense rehydration! I'd rather a juice box that they finish and toss myself.
     
  19. suej

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    Although we are going a bit lower carbs my attitude with treats has been and still is, if you can count it, you can bolus for it and eat it (so he counts carbs happily) - I know, much easier on the pump, previously on MDI Ben might elect not to have a snack if it meant another injection. But he does feel unwell above about 180. He would definitely have had the cupcake, but would prefer ice water - we do use juice at night for lows so he is "over" juice.
     
  20. Christopher

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    Yes, of course responsibility for taking care of your diabetes can be taught. It just can’t be forced on someone. Or by using guilt (look at Johnny, he didn’t eat a cupcake!). You can teach it through education, through your actions, through being a role model, etc. It seems a lot of people focus on food choices or how many cupcakes a child eats, how many carbs are consumed per meal. But for me, it is more of a holistic approach, focusing on the emotional and psychological, as well as the physical well being of the child.

    As for rewarding a child for their A1c, I have always thought that rewards for diabetes compliance was a bad idea. There are so many factors that influence a child’s bg, and in turn their A1c, that are not in their control, it doesn’t make sense to reward/punish for a particular A1c number. I will add the standard disclaimer that of course we all deal with this disease differently and each family needs to decide what works best for them and there is no right or wrong way, etc….
     

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