Community

Is your child not looking both ways when crossing the street?

Is your child

  • Scaring you to death while walking around town?
  • Needing constant check-ins or supervision?
  • Forgetting your phone number and street address?
  • Forgetting how to use a cross-walk and to wait for the green light?
  • Leaving belongings all over the place; forgetting his wallet at the store?
  • Seeming unaware of her surroundings, even with constant reminders?
  • Wandering off at an amusement park, the zoo, or the mall?
  • Struggling with community skills like crossing the street, making a purchase, or counting change?

LET'S TALK ABOUT IT

Some children are not as quick at learning daily living skills. Perhaps you are the parent of a 9-year-old, and you are wondering “Why can I still not let this kid out of my sight for two minutes?”

You may be walking through the mall and suddenly realize your child is no longer next to you. As you run the halls, yelling her name, she pops out of the candy store, looking oblivious. It may be that you are on a first-name basis with customer service at the grocery store, where you are constantly paging your lost child on the loud speaker.

When you are out-and-about, you may find that your child cannot keep track of his things. You may see your son leave his wallet on the seat of the taxi or your daughter leave her jacket on the floor at the movie theater.

Children mature at different rates. You may find yourself thinking, “how is my little bird ever going to leave the nest!” Sometimes parents make the mistake of too much hand-holding. Alternately, sometimes parents assume a child with a delay or disability ‘should’ be ready for more independence than he or she really is.

CLINICAL DESCRIPTION

Daily living skills are also called ‘adaptive skills’ and include the ability to function within the home and the community. Community living includes remembering to look both ways before crossing the street, going on an outing with a peer, taking the bus or making an appointment on time (for older teens). Clinically, we must consider that many children will struggle with independent living skills at one time or another.

Your typically developing child may do great in school but seem like she would lose her head if it wasn’t attached. Although there may be a slight delay, worthy of some support at home, it may not be cause for major concern.

It is important to understand, though, that children with disabilities often have challenges in one or more adaptive skills. Children with Autism may have delays across all adaptive areas. Children with ADHD may struggle with community skills because they do not pay attention to driving directions, think about how much change to receive from the drug store or maintain a schedule to organize their appointments.

Children with emotional challenges may also be delayed in their adaptive skill development. Anxiety and depression can lead to a slower development of appropriate self-care and community skills.

WHAT TO DO WHEN YOUR CHILD IS NOT SAFE IN THE COMMUNITY

If your child is struggling with the daily living skills needed for community living, several factors should be considered.

If your child is in the teen years and is slow to gain independence, it may be only a slight delay. It may be that your teenager cannot figure out the time it will take to get somewhere. He may think, for example, that you can leave at 2:15 for an appointment at 2:30, an hour drive away from your home. Your teen may always be a day late and a dollar short; showing up on picture day in a grungy t-shirt with no picture money.

Most children are driven, at least to a degree, toward independence. They generally want to be able to do more on their own. However, as a parent of a child who is delayed in community living skills, you may feel like it is dangerous to ‘release your child out into the wild’ for fear that he would not make it on his own. In a sense, this is true.

It is important help your child gain independence…and it is also important not to cut those apron strings too soon. Consider a gradual release approach. First, ‘I do,’ then ‘we do,’ then ‘you do.’ Do not expect your child to do it on his own and then panic and do it for him. Rather, expect him to struggle initially. Help your child only as much as needed and not more.

Many opportunities occur at school for your child to learn independence. The best example is to learn how to use a planner in middle school. Again, you would want to practice a gradual release approach.

Provide maximum support, and gradually withdraw your help as your child learns independence.

First, have you child’s teachers help your child write all homework and important events in the planner. If this approach is not possible, a school counselor or learning specialist can help your child with the planner at school.

Then, each night, check your child’s planner with him or her. Go over a plan for how each task will be completed. The more your child becomes solid with writing homework in the planner, the teacher can back off. It might be that your child’s teacher only checks for major assignments or only reviews it once per week.

Once that step is in place, you might start to check the planner at home every-other-day, then once per week, and so forth. The time spent helping your child learn to plan and gain responsibility will pay off in spades later in life.

If, however, your child is struggling in multiple activities of daily living, including self-care, chores, and participation in school, a developmental concern may be present.

Children who fall behind significantly in daily living tasks may have a disability and may require therapy. Applied Behavior Analysis (ABA) therapists and Occupational Therapists (OT’s) can help children who struggle with activities of daily living. If you suspect your child may have a disability, consider an evaluation by a psychologist (see ‘Where to go for help’ below).

SIMILAR SYMPTOMS

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

  • Social Skills (Socializing): trouble socially interacting with others impacts adaptive skills because social interaction underlies development. Children learn from engaging with one another. Children who are not paying attention to other children may have less community experiences and fewer opportunities to practice community living skills on their own
  • Communication Skills (Communicating): trouble with communication impacts a child’s ability to express his or her wants and needs, to develop conversation skills and to engage reciprocally with peers or others within the community
  • Intelligence: trouble with thinking and reasoning can cause overall delays that would encompass areas like communication, daily living skills, socialization and motor development
  • Motor Challenges (Moving & Sensing): trouble with motor skills can impact adaptive skills, particularly in younger children. Children need to crawl and move about the environment to engage and learn in their surroundings. Being able to get around independently has a large impact on community living
  • Attention (Focusing): trouble paying attention can impact learning; certain cues like the clock or calendar may not be attended to and perhaps mom or dad micromanages every aspect of life such that the child does not feel the need to pay attention to these community living routines

POTENTIAL DISABILITIES

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this information does not serve as a diagnosis in any way. See the ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

  • Intellectual Disability: children with intellectual disabilities have general delays across cognitive and adaptive areas. A child with Down syndrome or another genetic condition and children who have been exposed prenatally to drugs or alcohol may be more at risk. Cognitive abilities are understood to be partially genetic and partially environmental. Some genetic disorders may limit the cognitive gains that can be accomplished
  • ADHD: challenges with attention, impulsivity and hyperactivity often translate into lower skills in some areas, such as listening and following directions, getting things done, and self-care tasks
  • Autism Spectrum Disorder: deficits in social communication and restricted interests or behaviors can have an overall impact on adaptive skills
  • Language Disorder: Conversation skills, expressive and receptive language may be less developed in children who have language delays. These challenges can impact a person’s ability to navigate the community successfully
  • Anxiety or Depression: excessive worry or sadness that has an impact on day-to-day functioning; children with these emotional struggles may withdraw from peers, communicate less and let self-care skills decline. Very anxious individuals may develop fears about being independent and may avoid trying independent tasks because it is reinforcing to avoid something new

WHERE TO GO FOR HELP

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

  • Clear Child Psychology: to obtain a customized profile of concerns for your child or to consult ‘live’ with a psychologist
  • ABA Therapist: to help to improve behavior, increase adaptive skills and improve communication. In-home treatment plans make addressing self-care and domestic skills easier. This therapy is often covered by insurance for Autism Spectrum Disorders but can be helpful for other diagnoses as well like ADHD
  • Psychologist or Neuropsychologist: to consider a full assessment to examine symptoms in a mental health and/or behavioral context
  • Psychotherapist or Play Therapist: to treat emotional symptoms and anxiety as needed; to work on social skills via a social skills group or CBT interventions
  • OT or Speech Pathologist: to treat motor or language deficits. In combination with ABA, this approach may be most effective for children with Intellectual Disability or Autism

These professionals may recommend or administer the following tests for this symptom:

  • WISC-V: IQ test (Psychological or School Psychological evaluation)
  • Vineland-3: a comprehensive test of adaptive skills that includes communication, socialization and daily living skills. Other adaptive measures include the ABAS and the SIB-R, which is the best measure to use for an adult.
  • TOL-2, CTMT, WCST, TOVA: executive functioning tests (Neuropsychological evaluation)
  • ADOS-2: social communication test for concerns indicating an autism diagnosis should be considered
  • Roberts, BASC-3, Clinical Interview, RCMAS, CDI-2, Human Figure Drawing: social-emotional tests. The BASC-3 also has adaptive domains to assess flexibility, social skills, leadership, and functional communication. (Neuropsychological or psychological evaluation)

LEARN MORE

[1] Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

[2] Barkley, Russell A. (2013). Taking charge of ADHD, 3rd edition: The complete, authoritative guide for parents. 

Amazon: https://www.amazon.com/Taking-Charge-ADHD-Third-Authoritative/dp/1462507891/

For Kids:

[3] Cook, Julia (2012). Personal space camp. 

Amazon: https://www.amazon.com/Personal-Space-Camp-Julia-Cook/dp/1931636877/

[4] Esham, Barbara (2015). Mrs. Gorski, I think I have the wiggle fidgets. (New edition) (Adventures of everyday geniuses.) 

Amazon: https://www.amazon.com/Gorski-Fidgets-Adventures-Everyday-Geniuses/dp/1603368175/

[5] Smith, Bryan & Griffen, Lisa M. (2016). What were you thinking? Learning to control your impulses (Executive function). 

Amazon: https://www.amazon.com/What-Were-You-Thinking-Learning/dp/1934490962/

Image Credit:
Description:  Car stopped for pedestrian
Stock Photo ID: #163654089 (iStock)
By: Tepic
How-to-keep-your-child-safe
Previously Licensed on: November 30, 2016
Stylized by Katie Harwood exclusively for CLEAR Child Psychology

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