Monday, August 6, 2012

On-Call with Dr. Nyiri Grigorian, LCSW, Phd

"Can I Have One More Book Mom?” and other bedtime issues!

Nyiri has been in private practice for twenty-five years treating children, adolescents, and adults, as well as families and couples. Dr. Grigorian not only specializes in anxiety and depression, but has treated couples in Parent Guidance for decades. She supervises a wide range of therapists professionally who are in the mental health field. Dr. Grigorian has lectured and conducted workshops on a wide range of topics, including sibling therapy, early intervention in childhood development, and prevention in mental health. She has also served as a consultant to many school districts and non-profit organizations identifying high-risk children and families. She has contributed to the body of research on treating siblings together as an alternative to traditional individual treatment. She has been part of long-term research group studying trauma.

As a relationship specialist for the Bedtime Network ( Nyiri contributes weekly stories providing advice on a variety of sleep topics. Pedimedica found the following published article to be beneficial to their readers and wanted to share her perspective on dealing with the difficulties of getting their youngsters to bed!

“One of the most frequently asked questions in clinical practice with parents of young children revolve around BEDTIME strategies and difficulties. Sleep and how to get more of it is the number one question on parents’ minds! It can be at the root of parent fatigue, guilt, anger, and marital strife. Very often, for example, when treating couples in marital therapy, the theme of putting children to bed at night comes to the fore as a central focus. In some families, there is the dread over the impending bedtime and, it is often viewed as another chore at the end of a long day.

In the same way adults frequently feel it is never a good time to get married, get pregnant, buy a house, move, change jobs, or go back to school, they feel too, that there is never a good time to tackle a child’s bedtime issues. In a like manner to adult concerns, children are teething, sick, having separation anxiety, coping with the birth of a sibling; starting nursery school coping with a new babysitter etc…There never seems to be a good time.

One of the things most helpful to acknowledge before tackling bedtime problems is: always REMEMBER that when you are putting your child to sleep at the end of the day, you are at your most fatigued and vulnerable. Your mind could still be on the toys that are all over the floor downstairs, laundry that is undone, and…bills. Although it sounds simplistic, one of the most dramatic things a parent can do (if married or with a partner) is to be in AGREEMENT about the bedtime approach. For example, that means that one parent isn’t angry at the other while they are playing airplane and wrestling 20 minutes prior to bed or resentful that their partner jumps at every whimper, sound and move their child makes.

How can we create a stress-free bedtime? How young children sleep at night very often is connected inextricably to what goes on during the day. We need to remember that toddlers, preschoolers, and latency age children sleep dramatically better when they are tuckered out from plenty of exercise, fresh air, and activity during the day. Since children are consuming many hours of television a day and are involved with electronics at a VERY young age, they are exercising less and less. Passive activities have replaced playing at the park and playground, running and playing in the fresh air.

Napping can also be a major culprit when identifying difficulties at bedtime with young children. Parents can be reluctant to shorten naps or eliminate them altogether thereby enabling them to have more time to themselves. After all, who wants a cranky child on their hands? Phasing out naps slowly and shortening them can have a major impact on how easily and what time your child goes to sleep. One must work hard, for example, keeping your child awake in the car in the later afternoon so that he doesn’t go to sleep.

Consistent bedtime routines are KEY to a smooth transition at bedtime. Setting the same time every night is the single most helpful bedtime ritual and the addition of a soothing bath, brushing teeth with a special toothbrush, a small stack of books to choose from, or a short song can all make the pleasure and safety of bedtime better for children.

Since bedtime for children can summon up separation issues and fears, it is crucial for them to feel in CONTROL. For example, one can give them a choice of books to read, which stuffed animal to sleep next to and which “night-night” song to sing.

If children are frightened to be alone, one can sit in the room with them and leave for brief intervals, checking in every five, ten and fifteen minutes. Let them know you’ll be back to check on them. Don’t attempt any long-winded explanations of why they have to sleep. Keep everything loving, comforting, simple and short. Don’t forget to verbally and physically reward your child when for several nights in a row, they have gone to bed well. Three nights become one week, and one week becomes two weeks. Simple rewards and treats, for example, even a new colourful pack of markers or stickers, can show your appreciation. Before you know it, your child will be in the land of Nod.”

Dr. Nyiri Grigorian, LCSW, Phd.   published 10/1/11 issue