Creating Emotional Ideas
The child’s ability to form ideas develops first in play.
The child uses toys to weave stories, and through these stories he
experiments with the range of intentions and wishes that he feels. Baby
dolls are fed by Mommy dolls. People inside a house are threatened by
giant bears. Cars crash into other cars.
Along with this idea-laden play comes expanded use of words.
At first the child merely labels the important elements of his
world—the people on whom he depends, his favorite foods and toys—or
commands imperiously, “That!” to indicate a desired object. In time, he
adds dialogues to his play. Later, with help from his parents, he puts
names to his range of intentions, wishes, and feelings.
Through idea-laden play and expanded use of words the child is learning that symbols stand for things. The empty box in which he bathes his doll is a symbol for a bathtub. The word bath is a symbol for his activity in the tub. The word mad is a symbol for that bursting feeling he had inside. Each symbol is an idea, an abstraction of the concrete thing, activity, or emotion with which the child is concerned. As he experiments more and more with pretend play and words, he becomes increasingly fluent in the world of ideas.
Eventually he is able to manipulate ideas, to use them in ways that meet his needs. For instance, he can see, hear, and feel Mommy when Mommy isn’t there. Now when he wakes at night, instead of simply crying, he can call for her. Sometimes just picturing and thinking around his mother is enough to comfort him. When he is thirsty, he can thing about juice and say, “Mommy, juice,” instead of hoping she will know what he wants. With this new ability to manipulate a world of symbols, he has made the leap to a much higher level of communication and awareness.
Ryan had had numerous medical problems and surgeries as an infant, and although he was healthy at age two and a half, he had difficult, disruptive behaviors. He never slept for more than three hours at a time; he rejected most food and was significantly underweight; and he was active and irritable.
The preliminary evaluation
showed that Ryan has mastered the earliest milestone. He evinced an
eager interest in the toys in the office and was able to keep himself
calm. But his skills at intimacy and two-way communication were
intermittent. He often turned his parents out, refusing to interact and
ignoring their words and gestures, but when motivated, he could string
numerous gestures together to express his wishes. For instance, he
pointed avidly at a dollhouse on a shelf until it was placed on the
floor and then he methodically opened and closed all its doors and
windows; but he showed little inclination to use the house to play out
any ideas. When offered some dolls, he mechanically put them inside,
but he didn’t create a story. His use of words was limited also. He
used some single words, such as door, but didn’t use words to interact
with others that occasionally to say “no” or “out.” It seemed that Ryan
had not fully mastered the earlier milestones, and hence his ability to
tack milestone 5 was impaired.
Observations of Ryan at play brought to light something else about him: his range of emotions appeared constricted. When things went wrong, he didn’t get angry; when they went smoothly, he didn’t smile. He was interested in the toys in the office but exhibited little curiosity. And when his parents tried to hug or encourage him, he showed no evidence of warmth or pleasure. His mother had described him as “always negative,” and it was easy to see how this sullen little boy could seem so.
As part of the evaluation an occupational therapist discovered that Ryan was tactilely oversensitive in and around the mouth, which accounted for some of his pickiness about food. He was also posturally insecure, that is, not comfortable with how his body felt as it moved through space. A foot’s moving off the ground made him feel uncertain and unbalanced.
Observations of Ryan and his parents playing together revealed that Ryan’s sensory difficulties were only partly responsible for his problems. The way his parents played with him contributed also. In their efforts to engage Ryan, his parents were a little too quick to offer ideas; as a result, they hampered Ryan’s ability to develop his own ideas. For instance, Ryan’s mother handed him a doll. “What’s this?” she asked. When he didn’t answer immediately she said, “That’s the boy doll. What’s this?” Again he didn’t answer immediately. “That’s the girl doll,” she filled in. “What do they want to do together?” Once more she supplied the answer. Ryan responded by turning away. His mother then put a puppet on her hand and said, “What are you going to say to the puppet?” When he didn’t respond she said, “Say hi to the puppet. Say hi.” Ryan turned away, then he took a block, put it on another block, and toppled them over. Ryan’s father behaved similarly with his son. If anything, he was more directive, and Ryan’s gestures and responses were even more limited.
Ryan’s parents gave him so
little room to move that turning away and making negative gestures had
become his only way to assert himself! This emotional tendency was
enhanced by his sensory patterns. His postural insecurity made him
inclined to be passively negative—to turn away rather than to hit or
kick—and his sensitivity around the mouth predisposed him to be negative
when it came to food. Perhaps his inability to sleep was just one more
way to assert himself with his parents. By tuning his parents out he
gained some space for himself, but in the process he limited his chance
to develop his own ideas.
The treatment program, in
addition to working on Ryan’s oral oversensitivity and muscular control,
worked with both parents on their interactions with their son. They
had to learn to give Ryan time to respond before offering a response or
their own. They had to give him room to initiate play. Gradually both
parents learned to be very engaged with them. As they did so, Ryan
became more engaged with them. He also began to show some leadership.
In one session several months later, he put a whale puppet on his hand
and held its mouth open. Instead of directing the action as she would
have in the past, his mother put a puppet on her hand and had her puppet
say, “What do you want, Mr. Whale?” Then she waited patiently for
Ryan’s answer. Ryan said the whale was hungry. Instead of feeding the
whale herself, his mother asked, “What does he want to eat?” Ryan,
taking a great deal of verbal initiative, generated a list of foods the
whale wanted. As simple as this little interaction was, it was a major
improvement in the family dynamic. Rather than telling Ryan what to do
at each juncture, his mother had let him direct the play and inspired
his initiative by joining him in his drama. She became a player in the
drama; but he was the director.
Some weeks later, Mom and Ryan played with the whale puppet again. This time, the whale spit out its food. “How does the whale feel when it spits out his food?” Ryan’s mother asked. Ryan didn’t answer. “What does the whale want to do?” she asked. Ryan then had the whale bite everything in the room. When the whale finished biting, he knocked down some toys. Ryan’s mother watched. When he was through she said, “Is the whale mad or happy?” “Mad,” said Ryan. Then he smiled. This was the first time Ryan had expressed anger in the form of ideas.
Ryan’s father made similar strides. Around the same time, in a session with his father, Ryan noticed a flashlight. “What’s this?” he asked. Instead of grabbing it, his father responded, “Let’s see if we can figure it out.” He pointed to the switch. Ryan began pressing the switch, and after a couple of times the flashlight turned on. Ryan giggled. Then he shone it at his father, and his father made funny faces. Then they switched—Ryan’s dad shone the light at Ryan, and Ryan made funny faces. Through this little exchange both Ryan and his father laughed. Their exchange was warm and intimate, and for the first time, clearly pleasurable for Ryan.
Suddenly Ryan got an idea. He said to his father, “Me,” pointing to the flashlight. When his father shone the light on him, Ryan stood in the spotlight and pretended to be onstage. With everyone watching, Ryan pranced and preened. When his audience applauded, he performed some more. This was an enormous step. For the first time, Ryan initiated a complex drama in which his parents and therapist were importantly involved. With help from his parents he was opening up to the world of emotional ideas, strengthening his skills at intimacy and communication. He was cementing his hold on the earlier milestones, and he was making good progress on milestone 5.
From Theory to Practice; Tips on how to help your child master stage 5
Goal – Using symbols or ideas to convey intentions or feelings.
Now is the time to help your child tell you what he wants or thinks, and to become a partner in his emerging make-believe play. You can pretend to be a puppy, or talk for a puppy puppet, and ask your child for a hug or a kiss or a dog bone, for example. You can also open up conversations with him about his desires and wishes, and ask, “What do you want to drink, milk or juice?” His reply of “juice” could be met by your eager head nod and response of, “Let’s go and get it! Show me where to go.” As he answers, “There, Mommy,” while pointing toward the refrigerator, he’ll know that he can get his needs met by interacting with you.
Stage 5 Do’s and Don’t
Games to help your child master Stage 5:
Using your child’s natural interests, see how many back-and-forth circles of communication you can get going using words, phrases, or short sentences. You can even turn your child’s single-word response into a long chat. For instance, when your child points to the door and says, “Open,” you might reply, “Who should open it?” He is likely to say “Mommy do it,” and you could shake your head from side to side and say, “Mommy can’t now. Who else?” He’ll probably turn his head to his father and ask, “Daddy do it?” Daddy might reply, “Do what?” When your child once again points to the door and says “Open, open!” Daddy can walk toward him saying, “Okay, can you help me push the door open?” With his eager head nod, your little boy will be closing this long sequence of back-and-forth words and gestures.
Become a dog or cat or superhero in a drama of your child’s own choosing. Ham it up and see how long you can keep it going!