Only Change One Thing at a Time

Many of you may know by now that we have a boy (Nick) with special needs. He’s our little sweetie, and these days, his good days far outweigh the bad days. But this wasn’t always the case. Figuring out what is bothering him can be nearly impossible at times because he is non verbal and has great difficulty communicating his needs. His frustration peaks to the point of self-abuse. He’s loaded with sensory issues, and he’s a creature of habit. So any change in his routine can really throw him off. And if there’s one thing we have learned along the way that I think everyone who has a child with special needs who is non-verbal, thrives on routine and/or has sensory issues should know, it is this:

If it is at all humanly possible, never change more than one thing at a time.

This means:

• Don’t change the furniture in a room around and change a medication at the same time. New medications, or even just a different dosage of a med they’ve been on, needs to be monitored for awhile. And you’ll need to know that if your child starts to act strangely, it’s not simply because you moved the furniture.
• Only change one medication at a time. Two meds can have the same side effects. And sometimes odd, unexpected side effects can occur. There was one med that we tried twice to put Nick on to prevent him from rejecting his transplanted kidney. Both times he would dig at any piece of skin on his body that he could get his hands on. The first time we put him on it, the doctor couldn’t imagine that it was the med causing this behavior. The second time it happened, we knew for sure that it was. Who knows how this drug made him feel to cause him to do this. Itchy skin? Creepy crawly feeling? Maybe it had nothing at all to do with his skin…
• Don’t get a new car and buy a new bed for your child in the same week.
• Don’t drive a different route to daycare and buy them new shoes the same week.
• And if you have to move from one home to another, don’t change anything for as long as possible. Moving from one home to another was extremely difficult on Nick. He couldn’t poop for two weeks and was self abusive to the point of having to restrain him all day. I don’t look forward to ever moving again.

You get the idea of what I’m saying. You’d be surprised at what might throw them off. Think of the tags in the back of shirts. They never bothered me unless the stitching wasn’t soft, but they drive other people crazy and they cut them out of the shirt. And now you see shirts where the tag is printed on the inside of the shirt instead of having a regular tag. The same thing goes for our kids, only what bothers them, and how they react to it can magnify quickly.

If communication is a problem, then you need to be able to watch for signs of adverse reactions to any changes in a child’s life. If your child is older, you probably already know what these reactions might be. But if you are new to this wonderful world of special needs and you’re not sure of what to watch for, you could start with some basics:

• Know all of the possible side effects of medications that they are taking.
• They could have a change in their sleep habits.
• They could simply become agitated, as any child might. Talk with the child’s OT and see if there may be some sensory issues, and ask them what might help (weighted products, extra sensory input, etc.)
• Change in bowel movements.
• They may become more withdrawn.
• They lose interest in what they used to love.

I’m sure there are plenty of other signs that a child is adversely reacting to change. And you will inevitably run into some difficult days because of something that simply needed to be different. If changing it back isn’t feasible, or your child needs to learn to deal with the new change, you can offer some comforting items or activities. Your child’s OT can be of great assistance when it comes to this.

Here’s what helps Nick:

We’ve found that Nick loves to be squished. When I lay with him at night while he falls asleep (yes, he is a little spoiled), he loves to have my arm across his chest. He also loves to be wrapped up in a sheet or a blanket like you would wrap a newborn baby. He has a weighted blanket that I use on him in the car, and we have a weighted lap pad for him for every day use. I think that maybe the motion in the car can be a little too much for him, especially with his vision problems. Before I discovered weighted blankets, we rarely made it from point A to point B without having to pull the car over because Nick was hurting himself. Now, with the blanket on him, he’s content in the car 99% if the time. We can often get away without using the blanket now.

He also has a Body Sox. It’s like a giant, stretchy pillow case for people. You buy one that is just a little shorter than the child is tall so that it puts pressure on their shoulders, feet, and even their head if they want.

An iPod with muff style headphones have saved the day more times than I could possibly count. He loves the pressure on his ears, and the music definitely has a positive effect on him.

Changing more than one thing at a time will only complicate your life, and cause undo stress for your child. Sure, this may mean that you may have to do some planning in advance, or even put of a change for awhile. But if you get yourself into a situation where you’re child’s extremely upset, and possibly self-abusive and you can’t tell what’s bothering your child because you’ve changed more than one thing in their life recently, you’ll know you won’t want to do that again too soon!

And then on the flip side, a small change can be good. For example, Nick hates simply being moved from the car seat to his stroller. So when we get close to home (he now recognizes where he is), he’ll often begin to hurt himself. So if I think this might be the case on a particular day, I’ll take a little detour to throw him off. We’ll be pulling into the driveway before he realizes it’s almost time to be moved.

So, that’s my two cents for the day, whatever that’s worth. Hopefully it helps someone, somewhere!

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Take Care ~ Lorna