A little advice needed

[lynned55]

Or rather your thoughts on an issue we have.

 

We had a little boy start with us in Sept. He does all day Monday (7 hours) and Tues, Weds afternoons (3.5 hours) He's just 3 (beg Sept) and is still in nappies. Lovely little boy, developmentally where he should be, no concerns at all.

 

The first couple of weeks he was with us he didn't do the full day on the Monday and didn't require a nappy change. the first full day he did, his KP changed his nappy lunchtime and had no problem.

The following Monday week she was off sick and it was pretty obvious by 11 am that he had a dirty nappy. Some one (a very familiar member of staff) took him to change his nappy and he went crazy, trying to run out the door and screaming for his mum. We managed to calm him down and get him back into the playroom where he was quite happy as long as no mention was made of trying to change him. So I ended up ringing his Mum asking her to come back and change him. It took her an hour and half to get back to us and by that time the whole of the preschool stunk. Anyway we had a chat and she said that he was a bit funny sometimes about other people changing him or dressing him. So I just said well you will have to be contactable and prepared to return if we need you as obviously he cant be left like that. She agreed and went off 30 minutes later he had done it again. Same as before hysterics at just the mention of it- so I rang her about 4 times before she answered to be told she was in a 'meeting' (she doesnt work) that she had abandoned because we had called her back in earlier. Anyway to cut a long story short she eventually got her mother to come back to us but over two hours after I had first rang her.

So now we have had half term and Monday same problem except this time I said if he wont alloww us to change his nappy you will have to come back to do so. She said ok. Well he didnt and again she took so long to get back to us that by the time she did the nappy had leaked (thankfully only wee this time) and his trousers were soaked. It was horrible as we couldn't allow him to move around the room like that, sitting on everything so we had a staff member watching him all the time. By the time she turned up I was really cross, I think she is living now in a different borough to the address she has given us (although she says the address she has given is her correct one) and also she is picking up her daughter from our local school, which coincides nicely with our finishing and start times. By coming earlier she is then hanging around for maybe and hour or more before school finishes.

 

So after a lot of thought and chatting to Mum we have come up with an 'action plan' which is she will change him when she brings him in with his KP in there as well maybe passing her wipes and the nappy until he gets used to her being there and starts to trust her. Also mum has agreed to be back with us within 30 minutes of us calling her. Except I really dont think its a trust issue as he's happy to go to staff when he comes in let us help with coat, nose wiping, washing hands etc and will go to his KP for comfort if he hurts himself.

 

Any thoughts or advice? We've tried everything: offering a different room, standing up, laying on mat, him doing it himself everything we could think of. In over 20 years I've never had this before had children that have got upset over wearing our change of clothes but not flat out refusal and hysterics over changing a nappy- he wouldn't even let us change his trousers to a dry pair.

As I said earlier there are no other concerns over him. He's a very happy little boy and really it isnt even the refusal to allow us to change him that is an issue I suppose it's his mothers inability to get back to us within a reasonable time.

So have we done the right thing? Sorry its a very long winded post but wanted to get it all down

 

[zigzag]

Oh my goodness I really feel for your situation. I think you have been incredibly patient both with the child and parent and I think that involving the KP in Mum changing the child is a good first step. I think that On the occasion that it took Mum 2 hours to return and he was obviously dirty I would have forced the nappy change for everyone's sake. I know that may be controversial so I am ducking when I say it! I am guessing that you are doing lots of role play with babies and nappies, reading books around nappies and potty training. What about trying to encourage Mum to start toilet training as this would then avoid the need for changing.

Wishing you luck.

[narnia]

We had the exact same problem with a boy at our setting a few years back....................and I'm sorry, but I absolutely will not leave a child in a nappy that needs changing, andI wouldn't call a parent to come back to do it either..........................anyway, what worked for us, was asking the child to fetch a clean nappy from his bag, plus any other things he needed. It was almost like putting him in charge of the nappy change, but honestly, it changed him from having the screaming abdabs, to a smiley little boy, happy to have his nappy changed

[finleysmaid]

I think you need to look at why this child is behaving like this....is it control? fear? etc this might then give you the answer as to how to go forward

[lynned55]

But how do you force a child to have their nappy changed? The only way to have done it would be to physically hold him down and that would have taken 2 members of staff plus a third to actually change him. I'm not about to start physically restraining a child to that extent- Narnia- we've tried all that but we cant get him out of the room to do so. We've even bought the stuff into the room, tried saying 'come with me' and as soon as we're out and into changing area he starts screaming. Tried offering a friend to come but nothing.

 

I'm beginning to wonder if it's a control thing. When Mum turned up on Monday he came out of preschool quite happily and whilst I was talking to her came running out with changing mat - saying here you are Mummy, then laid down on there quite happily for her.

 

Anyway- we start this on monday so will see how we get on.

[Inge]

Does sound like a control issue, he has learnt that if he refuses a nappy change mum will come .

 

Maybe try to get mum to not interact while doing the change, no attention from her at that point, change and go.. interaction to come from the KP who is there helping. I would also suggest that he could be ready for toilet training as he seems to be aware of his needs..

[blondie]

we had this problem with a child -he would only allow his mum/ nan to change him but we worked this through with them by being alongside mum/nan as they changed him until he was happy for us to gradually take over part of the routine each time until we were doing the whole thing with mum/nan alongside.

he would always take in a train with him (they were his obsession) and play with this as we changed him - does your child have anything he particularly likes to play with (from preschool or home) that might help?

Edited November 3, 2016 by blondie

[narnia]

we also have posters next to the changing area...Thomas the tank engine and some lovely old painting posters with things hidden in them, so that causes lots of chat.

 

I honestly, with my hand on my heart, have ever had to have someone hold a child down so I can change them and I would absolutely not leave a chld in a nappy that needs changing for more than a couple of minutes maximum. If it is really a control thing, then perhaps once he realises his nappy is going to be changed even if he yells about it, then he will calm down and let you get on with it. Stay calm and just get on with it and he will do the same, even if it takes a little while, then praise him like a crazy thing for getting it done so well.What do you do if for some reason you CAN'T get hold of mum, or anyone else to come back to do it?? Are you going to leave him soiled or wet all day??

[lynned55]

In over 20 years of childcare I too can honestly say I have never had to have someone hold a child down or call a parent back to do it. We have always managed to work around it or find a solution however this time I am really stumped! I absolutely refuse to change a child that is physically fighting us not too have it done. Doesn't matter how firm we are with him short of literally dragging him by the arm or carrying him kicking and punching there is no way of getting him out of the room. The one time we did by 'tricking' him and him not realizing what where he was going, when he did realize instead of having all the mayhem in the hall it was going on in the foyer for anyone in the street to see and with him trying to get of the door. So that's not really an option.

 

Hopefully by sticking to our plan (which is virtually the same as you are suggesting blondie) we will manage to work through it.

Mum has said she has tried to toilet train but that at the moment he's not interested. She said all he did was wee everywhere last week. Although we have had no concerns over him - he does seem to have led a chaotic home life. Parents have split, spending one night with dad, time with Mum and also with his Nan, who seems to play a large part in his life and who he obviously adores. So I do wonder if it is a bit of a control thing.

[narnia]

I would consider my position on this. If it came down to a choice between leaving a child in a filthy nappy, or having him shout at me for two minutes, I would change him. If i really couldn't face it, I would have to tell the parent that ours was not the right setting for her child.

 

Oh, and I see you your 20 years and offer you my 40.... .

[zigzag]

Right call me a dinosaur here, but this is a three year old dictating to adults! No way, that is not how it is done, there are times when children have to do as they are told, like it or not. What is he going to be like as a teenager if he is dictating like this now! I see parents letting the children totally run rings around them and being given far too much control for their age and understanding. What happens when this child refuses to hold an adults hand and runs into a road!

[GFCCCC]

I would consider my position on this. If it came down to a choice between leaving a child in a filthy nappy, or having him shout at me for two minutes, I would change him. If i really couldn't face it, I would have to tell the parent that ours was not the right setting for her child.

 

Oh, and I see you your 20 years and offer you my 40.... .

Totally Agree

Right call me a dinosaur here, but this is a three year old dictating to adults! No way, that is not how it is done, there are times when children have to do as they are told, like it or not. What is he going to be like as a teenager if he is dictating like this now! I see parents letting the children totally run rings around them and being given far too much control for their age and understanding. What happens when this child refuses to hold an adults hand and runs into a road!

Totally Agree

 

If you fetch the parent in every time the child does this, he will just keep doing it. Children can control adults with certain behaviors, usually related to eating, sleeping or toileting. Has to be nipped in the bud quite quickly. Meeting a child's individual needs sometimes means doing what you know is best in the long term.

Edited November 3, 2016 by GFCCCC

[blondie]

sorry my post should have read that the only time we had this problem was with an autistic child who we worked with mum/nan.

other than that time we (luckily) have never had this with any other child.

[lynned55]

So what you're saying is you would get someone (probably 2) to physically hold him down whilst you changed him, after dragging him into the changing area?

[zigzag]

We would do it in the nicest possible way, firm, no fuss from the adult, just do it and praise loads after.

[finleysmaid]

have you tried the first this then that approach. I.E he wants to go outside so nappy first then outside...or he wants to play with cars...nappy first then cars. Load the praise, so he goes in the bathroom (to wash hands?) he gets a sticker...goes in to the loo...gets another....pulls at trousers another etc etc (till he has a shirtfull!!) ...im sure you've tried this. It does sound very controlling, unfortunately shouting till someone calls his mum is only going to compound this I suspect

[lynned55]

I promise you we have tried everything, short of saying you have to stand there and not move- which I suspect he would do.

 

zigzag- how firm is firm? If a child is just flatly refusing to move or running around the room,screaming. Your only option is to drag them?

[zigzag]

No Of course I would not drag them but I would pick them up and carry them.

[twinthinguk]

I had this today, the child refused to let 2 members of staff change him, eventually they managed to change his pull up ( oh how I hate them!) and then he spent at least 15 mins trying to undress himself as a result! I spoke to his nan who picked him up, she says he is like that at home but she does not stand for any nonsense!!! I cannot physically hold him and change him single handed as I have an injury to my arm, it took 3 of us to manage it today! I think a conversation with his parents will have to take place when he is in next week!

Edited November 3, 2016 by twinthinguk

[Foreveryoung]

We have had a good few who react like this, one did for a very long time who was 4 nearly 5 and very big and strong. As soon as it becomes apparent extra support is needed at changing time we get the parent in and do a support plan, it is clear what we will do and parents input into it as well with their ideas etc we detail how for example it will be carried out, how many staff, what staff do and so on. An incident form is completed to document the restraint if it falls into this during the change. One staff member usually does the legs and bottom area (or this has on occasions taken 2 separate staff) then another chats, laughs gently holding the hands of the child where needed. Facing away from the bottom area to focus all on the child. We have found some times it's better on changing table others it's better on floor. I have previous life worked with children with sen and had to change 9 year olds for example who would bite, pull hair, kick etc and applied same technique.

Often it's about routine and once you crack that it's an easier battle, solid consistent approach, if it doesn't work it's changed but as a team again so it's the same every time, everyone uses same language throughout so it's repeated, clear boundaries and expectations not different staff trying different things which reduces the routine expectations. I very much treat situations like this with ASD techniques, if you feel it's a full physical restraint that's needed and may be needed at other points of the session I would get 'team teach' or another physical restraint training programme in for your staff if funds arnt great (as they never are) try to get 2 staff trained. If staff do different things even to the smallest degree from one day to the next the child can struggle and the battle for want of the word will be harder and longer.

It's hard when you don't know the child/situation or staff to give a great deal of advice but I'm just writhing from my experience in hope it may help.

[lynned55]

Thank you for your advice