Hydrocephalus Education & Behaviour for Parents

The Child’s Point of View

Children with ‘behaviour problems’ are often children who are experiencing problems and tackling them as best they can. For example, they could be experiencing:

Physical discomfort:

  • A shunt blockage or infection;
  • Migraine;
  • Low energy levels (some visible ‘perk up’ after a snack);
  • Hypersensitivity to noise (e.g. laughter, clapping, lawnmowers);
  • Hormonal changes (precocious puberty, PMT);
  • Food intolerance (diet may be implicated in about five percent of children with behavioural problems).

Unhappy relationships with other children due to:

  • Bullying (some children can be very cruel, and it is the most vulnerable children who suffer);
  • Not being included in friendship groups (children with hydrocephalus are sometimes ‘young for their age’ – although they can sound ‘old and wise’ – and they may get left out of things);
  • Not being able to keep up in some of the schoolwork (in some classes, children only learn to feel good according to how many other children they have ‘beaten’);

Problems in understanding:

  • Time (knowing the difference between today and tomorrow; between five minutes and five hours);
  • How to ‘read cues’ that will tell them what is supposed to be happening now, and next;
  • How to explain the difficulties they are experiencing (leading to frustration that can ‘boil over’ when they get home);
  • How to ‘stand back’ for a minute and think about what they are doing or are about to do.

Too few experiences of praise, due to:

  • Problems with balance and poor spatial awareness (difficulty in keeping up with others in PE, in the playground; ‘clumsiness’ in the classroom);
  • Difficulties with co-ordination and fine motor control (poor handwriting and ‘untidy’ work);
  • Difficulties in following instructions and discussions in class (few opportunities to be the one who ‘does exactly what s/he is supposed to do’ or who ‘knows the right answer’);
  • Difficulty in concentrating on, and organising their work (continually being ‘reminded’ or criticised for not paying attention or not ‘getting on with it’; for losing things or forgetting ‘where they are’ in their work);
  • A lack of independence in self-help skills (always having things done for them);
  • ‘Shyness’ about giving their own ideas and opinions (not often saying ‘I think’, followed by saying something no one else has said).

Everybody likes to be successful, and people tend to like doing the things they are good at. Children, just as much as adults, need to have lots of opportunities to succeed at things. If they get the idea that there is nothing they are good at, they will begin to have a poor image of themselves, and may become withdrawn, anxious and unhappy.

The Adult’s Point of View

It is very easy to jump to conclusions about ‘behaviour’. In the list below, each ‘difficulty’ is followed by a possible misinterpretation.

A difficulty in:

  • Concentrating (can be misinterpreted as ‘laziness’, i.e. needs to be ‘stood over’);
  • Following instructions (deliberate ‘awkwardness;);
  • ‘Getting on’ with other children (‘selfishness’ or ‘self-centredness’);
  • Knowing how to ‘talk’ differently to different people (‘cheekiness’);
  • Responding to a direct request for explanations etc. (‘stubbornness’);
  • Doing neat work and organising it properly (laziness, carelessness);
  • ‘Thinking it through’ before shouting out an answer (carelessness, not taking work seriously);
  • ‘Holding back’ – accepting that they can’t always have what they want, not ‘lashing out’ physically or verbally (‘bad’ behaviour, ‘spoiled’);
  • Accepting changes in routines, stopping one activity and starting another, when asked (uncooperative, stubborn, unreasonable).

Each of the above ‘difficulties’ represents a skill that needs to be worked on. (For some, ‘neat presentation’ might mean learning to use a word-processor.)

Working Together

It is sometimes difficult to accept that children can be experiencing a genuine problem even though teachers and parents are doing their best for them, but this can happen. They may be experiencing feelings of stress in school but may not react to it until they come home (or vice versa).

They may need help and praise to learn how to:

  • Talk about their feelings;
  • Talk about the skills they need (what they are expected to be able to do), and the skills they have (i.e. what they can do; what they have difficulty with);
  • Describe the help they need;
  • Repeat (whisper) instructions to themselves so that they can remember what to do.

Sometimes the problem does turn out to be a habit of ‘lashing out’ or throwing a tantrum every time they are displeased. In this case:

  • Use as few words as possible to explain what will be accepted and what will not (and don’t use the word ‘don’t!!’);
  • Be consistent, i.e. if you have said ‘no sweets’, don’t give in to ‘wheedling’ or shouting – distract them if necessary;
  • Help them to ‘practise’ behaving differently, e.g. by: ‘waiting’ and ‘holding back’
  • Explaining how they are feeling (they may need to learn new words);
  • ‘working off’ their frustration (in a physical activity);
  • Taking themselves ‘away’ for a while.

Make a point of praising every single thing that is possible to praise, without being ‘false’ about it, and never tell children that they are ‘bad’ – it is what they do that can be ‘bad’, but that can be changed. The ‘practice sessions’ need to be done when they are feeling calm and happy. They will not be able to listen to reason when they are in the throes of a tantrum.

The final resort is often the introduction of ‘sanctions’, but this may not help children who have a poor sense of time, as they can have difficulty linking up ‘cause and effect’, and don’t understand ‘fear of consequences’. (This can also be a problem for example in road safety, and safety in the house.)

Although it may be small comfort at the time, these behaviours usually improve over the years. This is especially true if they have a lot of positive experiences of success through:

  • Learning to look after themselves (washing, dressing etc., as far as is feasible);

  • Learning to do ‘family tasks’ e.g. making a cup of tea, buttering bread, cleaning etc.;

  • Learning to ‘notice’ when someone-else needs help and offering it without being asked.