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Diabetes, discipline, behavior, and parenting

Discussion in 'Parents of Children with Type 1' started by Jaedima, Dec 5, 2012.

  1. Jaedima

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    Does anyone else here experience particular parenting challenges when your T1D child has noticeably high or low BG levels? How do you handle those situations?

    The various parenting books / websites / advice I'm familiar with say things like, "Don't discipline kids when they're tired or hungry." Presumably they mean to wait when the child is better rested and fed. But if my child is behaving poorly due to extreme BG, that's a long time to wait until he's back in a healthy range in order to discipline him. Yes, if his BG is high, I'm going to do everything I can to bring it back down, but in the meantime, I need strategies that I can use productively to address his behavior. And the strategies that seem to work when his BG is in a healthy range don't work well at extreme BGs.

    Then there's advice for parenting "the difficult child" which says that such kids need a lot more positive attention and that they're seeking negative attention because adults' responses to misbehavior are much more interesting. OK, I'll keep working on recognizing and reinforcing desirable behavior, including more child-led time, plus bonding, relaxing, and enjoying my time with my child. But I don't think my child is acting out because he's *seeking* negative attention from adults. I think he's having trouble shifting his own focus from whatever distracting thing has caught his attention, to what other people want him to do. He gets much more distracted with extreme BG, enough that I can use that to tell when he's slipping into a low or when the carbs in his food are hitting before the insulin is.

    What strategies have you found successful for dealing with BG-related difficult behaviors?
     
  2. MamaC

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    How old is your child and how far past dx are you?
     
  3. Jaedima

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    He's 5yo, in K, dx'd 1 yr ago, been on Omnipod and Dexcom 7+ for most of the last year.
     
  4. MamaC

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    My child was significantly older at dx, but I let him know that behaviors caused by extremes of BG would be understood, but still acted on to some degree. For instance, angry displays would be shut down and he'd be removed from the situation (just as he would be if BG was not an issue). I also explained that he was not being blamed or held accountable for truly BG induced behavior, but poor behavior for any reason would be actioned.

    Your son may be too young to "get it" but establishing a system now would probably serve you (and him) well as he gets older.
     
  5. zoomom456

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    For my son, I notice definite behavior changes with low blood sugars and high blood sugars. Since he is 4, and mostly does not feel his blood sugar changes, we are trying to teach him to recognize his moods. William is starting, just barely, to tell us I'm really cranky. I think I need a check. This is generally, I'm low. William is easily distracted when he is high, but most 4 year olds are easily distracted by definition. Sometimes it helps us to set a timer for 5 minutes and tell him," When the timer sounds it will be time to get ready to go to the store. We check his bg before correcting his behavior. If he is low, we get the low up and talk about it as soon as he is able. If he is high, we explain we know he doesn't feel good, but the behavior is not acceptable. Depending on the behavior, he may go to time out. Some people do not agree with this way of dealing with his highs. The way I look at it, William most likely will deal with diabetes the rest of his life. Since I don't know when, or if a cure is coming, my job is to parent him to become a responsible adult someday. The world will not let him get away with bad behavior just because he doesn't feel well. I ask myself hundreds of times a day, would this be acceptable if he did not have diabetes? If I answer no, then I discipline him based on the offense. Again, this is just how I handle it. This works for us. Right now I can say my son is a happy, well adjusted 4.5 year old who behaves appropriately for his age.
     
  6. maciasfamily

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    We do this same thing. Our son is 3 and as a typical toddler and then a kid with diabetes, you could easily let him get away with anything. We however don't. It's usually very rarely that his behavior is due to his BG. Most times it's because he's a typical kid. He gets timeouts and toys taken away for not acceptable behavior.

    I feel you need to deal with the issues right now, and as stated above, they will need to learn how to deal whether they have high or low BG as they get older.
     
  7. Fixee

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    I'm a very recent dx, so take what I say with a grain of salt, but my 7yr old behaves horribly when he's low (and doesn't even feel it when high).

    But my feeling is that it's my job to keep him in range (70-180 for his age) 90% of the time. His lows are rare (1-2 times per week) and last only 30 mins or so. During those times, I give him a TON of slack. Why?

    Both his mother and her brother have similar mood swings based on being hypoglycemic (they are not T1Ds, they just get lows from not eating when they need to). In my mind, this is genetic. They are adults, and they have learned to eat immediately when they feel this coming on. But my 7 yr old is not that attuned to his body and we are just learning this T1D dance, so I am super patient with him.

    As contrasted to a poster above, I would not respond the same way without the dx (ie, I would be far harder on him if he weren't diabetic). So the disease is earning him some slack. I know you might say, "You are just enabling his attitude of 'I can be a jerk because I have diabetes' by tolerating this," and you might be right. I think the key is to stay connected with your kid's moods, pysche, demeanor as he ages and see if he starts to abuse the patience you give him, then adjust accordingly.
     
  8. cdninct

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    While I think this is a problem that a lot of us face, I think we have established that there is no one right solution--it really is one of those parenting problems!

    As far as I am concerned, I appreciate the fact that my son might not feel great when he is high or low, and I let him know that I understand that he is not feeling quite like himself, but for highs he gets whatever consequence is coming to him, and for lows, he needs to take some time to quietly regroup himself while he waits for the glucose tabs to kick in.

    All this relates back to his general behaviour, though; the kid is a high-strung limit pusher at the best of times, and if he's not made to toe the line constantly, it can be pretty disastrous! If he had a different personality, perhaps my strategies would likewise be different!
     
  9. cdninct

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    I can't imagine even the most exacting endo saying it is your job to keep him in range 90% of the time! I think it is wonderful if you are able to do it right now, but there will likely be times ahead as the honeymoon wears off (and puberty sets in!) when that will be impossible. I would hate for you to think you are "failing" your son when that happens. :cwds:
     
  10. MomofSweetOne

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    There's a difference in behaviors between highs and lows, too. I cut my daughter slack with lows for the whininess that can accompany them. Believe me, I hate whining and have never tolerated it other times. I've experienced lows; they're not fun and there's a desperation for food. They usually resolve quickly, too, unlike highs. The whiny tone in her voice usually disappears within the 20 minutes it takes for her BG to rise.

    I'm fortunate with the highs; my daughter becomes quiet and withdrawn. I can tell when she's above 170 for any period of time because she stops chattering.
     
  11. Lee

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    I never ever punish for behavior when low; We discuss when high. I grew up with a T1 step-dad and he did awful when low, such as punching my mom when she tried to feed him sugar. I have been around another T1 adult while low who exhibited very bad behavior. My feelings are if long-term T1 adults cannot control their behavior when low, why would I ever expect a child to?

    When high, the behavior is different. It is more mouthy and angry and sassy. In the past, I have said you had better be high or else! Now I don't say that, but I do check her BS when she acts poorly. But I act grumpy and angry when I am in pain. I hurt my back last week and was a real bear! Being high is extremely uncomfortable to some kids. So if they are only exhibiting poor behavior and attitudes, we discuss after their blood sugar comes down. But I don't punish.

    Kids do enough in life to be punished for.
     
  12. 3kidlets

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    Hana's moods don't swing too much with Lows or Highs. I suppose with Highs she is a bit grumpy. However, I would never punish her for her behavior in either of these extremes. I don't believe she has control. And I'm pretty certain of this because my father in law who is T1, is an extremely reserved, quiet, thoughtful man. However, I have seen behavior when he is low that is so beyond his normal behavior, that i know he has no control whatsoever. He becomes giddy, combative, argumentative. There is no way he knows what he is doing. As a matter of fact, I don't think he even recalls this behavior when he is back in normal range.
    If says something sassy to me when she is very high, I ignore it. I don't even address it afterwards. Because it will happen again. It isn't her fault.
     
  13. Jordansmom

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    My child is older. I also handle highs and lows differently. Bg aside, I don't tolerate mouthy bratty kids. But I cut my DD a lot of slack when she is low. There is such an overwhelming desperate and irritable feeling when low. I'm hypoglycemic and have experienced mild lows and as adult I can be crabby and miserable to deal with.:eek:

    With both highs and lows I'll always say something to her like "I know you dont feel good and it really sucks, but you are not allowed to hit your brother, yell and me, etc. no matter how youre feeling. Please do your best to control yourself." I'll be more firm about it if she's high. If she's low I ignore the behavior and try to help her calm down as best I can until she feels better. Either way I do always ask everyone in the house to give her a lot of space. I don't take it personally and try to stay extra calm about it.

    My DD was older at dx, so removing her or someone else from the situation that's becoming a problem has usually been enough. I also think a little prevention goes a long way if I can see the signs early and prevent the situation from turning into a fight. I do sometimes talk to her when she is not high or low about what happened and ask her to try to do better next time. It depends on if I think she could do better or not. I dont think she's proud of how she acts when she's not feeling well. We try not to dwell on it.

    I guess if my child was little I'd probably do a type of time out for bad behavior, in a comfortable place. But it wouldnt be a punishment really. More a way to remove my child from the situation until she felt better and could better control her behavior. Then when she was better I would have the same conversation I would have had immediately if she wasnt high or low, but I wouldnt punish or give serious consequences.

    I can see how it would be incredibly hard to parent a young child and teach them how to behave with bgs complicating things. I'd probably be second guessing my decisions all the time. But over time you do get some better at judging what behavior is bg related. Not always. There have been times when she's been argumentative and given me attitude and I've insisted she test and she's perfectly in range. Then there's always an awkward moment, when I'm thinking "Really? 100? Well then, don't you dare talk to me that way.":eek:
     
  14. SarahKelly

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    I really think it depends upon what they're doing. In our house there is just no tolerance for hurting another person either physically or with words. So, whether low, high or just right if the behavior is hurtful it is discussed. We don't "punish" per se but there are definitely consequences. If he is low or high that is addressed first, then the behavior second.
    If he is whining or uncomfortable due to BG we just take it like we would if he were ill, my husband has been wonderful at explaining to me how uncomfortable it can be to have BG extremely out of range. So, we say things like "your BG is low right now, you must be feeling shaky, hungry, maybe scared. Let's get more sugar into you and bring that BG up." or "Your BG is high, is your stomach hurting? Do you have a headache? Here have more water." We try and help him understand the feelings both physically and emotionally in hopes that eventually he'll find ways to help himself through those BG changes.
    Not sure if it helps, but just how we "try" (not always perfectly!) to do it here.
     
  15. Jaedima

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    It's really interesting to hear others' experiences and approaches. It sounds like many here have observed more challenging behaviors under extreme BG, but those behaviors can be quite different by the person.

    The problem I'm having is that my son seems to have much more trouble managing his attention under extreme BG (mostly when high, but sometimes also when low). Reminders, explanations, loss of privileges, logical consequences, etc. barely register because in the moment, they don't mean anything to him compared to whatever interesting thing has caught his attention. It's not necessarily gross misbehavior as much as it is just being off in his own world and not taking responsibility / following directions. At the same time that I recognize that it's harder for him to focus, I can't just have him ignoring directions when his BG is high. I need better strategies for redirecting his attention no matter what his BG may be.

    I guess what I'm realizing/remembering from this is that effective parenting strategies are what works under difficult circumstances, not just under easy circumstances. It's not good enough that I have strategies that work within a normal BG range; I need strategies that work at the extremes too. I suppose it's a mixed blessing for us as parents of T1D kids that we have concrete information that can help signal when things are more likely to be difficult. On the one hand, it lets us know that the problems aren't just a reflection on us as parents, but on the other hand, it's also feedback that makes us think about how to prevent the BG swings. I'm going to need to remind myself to focus on "redirect behavior now" and "better control of BG later" instead of wishing I'd done a better job with controlling the BG in the first place.
     
  16. Meredithsmom

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    Meredith was diagnosed at age 2. When her behavior would take a downward turn (like pulling out her sister's hair) I would check her bg before doing anything. Usually that meant holding down a screaming, combative 2 year old and poking her, getting blood and a number. If she was low, I would treat it. She rarely remembered what happened when she was low, so punishing her wasn't really an option. That was extremely hard for my other kids to understand as they were usually on the other end of the behavior.

    But, if she wasn't low, the behavior would have consequences. She was extremely upset the first time that happened, stating, "I have diabetes, you can't put me in time out." Well, I could and I did.

    Her highs usually don't have a noticible behavior change. But if I am suspicious, I test and, based on the number, punish accordingly.

    In the 4 years since her dx, she has learned that diabetes isn't an excuse for behaving badly and that she will be treated like everybody else when her bg is "normal." Not always easy, but she has to function in social settings.
     
  17. tiger7lady

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    This is the problem we have. If he is low he becomes very lethargic or goofy. If he's high then he can not focus on ANYTHING. Trying to direct him to do anything is practically impossible. I have to resort to standing over him and breaking down the task into little steps, giving him 1 step at a time. Sometimes that doesn't even work and I just have to wait out the high.
     
  18. JNBryant

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    My son is typically well behaved, but he does have his moments. He usually doesn't start showing symptoms of high or low BS until it gets extreme, so sometimes it's hard to pick up on it before his mood changes. When he's low, he tends to get really cranky and he cries a lot. We usually don't see hypo that often (thank goodness), but when we do see it, he's usually in the high 30's, low 40's. I don't punish him for the crying or crankiness when he's low, but highs are a completely different story.

    He won't show symptoms of high BS until he's over 250, and we usually don't see numbers that high unless he gets sick or if his vials need to be replaced. He's only 3, so it's a struggle sometimes when he's high because he throws massive temper tantrums and fights with his brother. I do discipline him accordingly when he's high after we talk about it. I don't want him to grow up using D as an excuse for behavior, nor do I want him to feel 'different' or 'left out'. I try to keep things as close to the way they were before his dx because I don't want his life to revolve around it, but he does get punished for his actions while he's high once we address it.
     
  19. Laura Ben

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    My little guy is 4 and my older non-D son just turned 6. Like alot of people said, I acknowledge and empathize with how he is feeling when high or low. I try to help him identify it but it does not change what behavior is acceptable. I.E. "I think the reason you are feeling so irritated with your brother right now is that your sugar is really high. You will feel better soon since you took insulin but it is still never OK to hit, scream... The consequence is xyz."

    My feeling is that if you don't treat a behavior consistently, you raise a child who believes feeling high/low is an excuse for bad behavior. I also know that my older child would end up very resentful if my little guy's bad behavior was excused every time he was high or low.
     

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