Monday, November 3, 2014

Week 63: Mind control

This week marked Lemon's second Halloween.  We observed it with about as much fanfare as his first--his "costume" was a hand-me-down jacket from a friend, so we joked that he was going trick-or-treating as "Elliot."  We went across the street to our neighbor's house to say hello before heading home so Lemon could go to bed at his usual time.  Now of course we're in that painful period immediately following setting the clocks back where Lemon claims to have no knowledge or understanding of the subject and persists in getting up at what is now 4:30 or 5 a.m.  So, Papa Bear and I still have the joy of being awake for an hour or two before sunrise, just like before.  Except now it gets dark at 4:30pm as well.  Awesome!

On Saturday we went to our clinic's annual CF Family Education Day.  It was great.  There was a video presentation from a lawyer who specializes in issues faced by people with CF, like accessing federal and state benefits and dealing with health insurance companies.  She has CF herself, and it was really moving to hear the emotion in her voice as she described her decision to leave a high-power/high-pressure career in a prestigious law firm to start her own law practice to focus on these issues.  Honestly I hope never to be in the need of her services, but it feels good to know that there is someone as dedicated as she is out there if we do.

There was also a really fascinating talk about how to get your kid to eat more, which if you have a kid with CF is a pressing issue at all times.  The speaker pointed out that these early years are especially critical, and how well a child is doing at age 4 is very predictive of how well they'll be doing at age 18.  Of course, the years before 4 are especially difficult, too, because it's impossible to use rational arguments to convince really young kids to eat.  Fortunately, our speaker (Scott Powers from University of Cincinnati) is an expert in child psychology and has developed a proven method that can get young kids with CF to eat an extra 500-1000 calories per day.

The premise of the method is that the most important reward for a young child is adult attention.  So, when do most parents give their kid attention during a meal?  When he's _not_ eating.  That's when parents come in with all kinds of strategies like coaxing the kid to eat, threatening him with a consequence if he doesn't eat, and so forth.  So, the kid learns that the parent pays attention when he's not eating or playing with his food, and that's what he does.  Dr. Powers recommends flipping the whole scenario around--praising the kid when he is eating, and ignoring him when he's exhibiting any undesired behaviors.  That way, the kid will learn that in order to get your attention during a meal, he actually has to be doing what he's supposed to be there to do.

We were really impressed by the results that Dr. Powers had achieved in his clinical trial, and tried right away to start implementing them at home.  He'd warned the audience that you will feel slightly crazy when you start implementing this plan, and it does feel pretty ridiculous to be sitting at the kitchen table saying "I really like the way you're drinking that smoothie right now.  That was an excellent bite of cracker."  The key, according to Powers, is just to shut of your self-conscious instincts and keep up the chatter while the kid is doing what you want, and being really diligent about ignoring them when they lose focus on the meal, even if they are trying desperately to regain your attention.  That, combined with even more strategies to boost the calories in the food, and you can get even a kid as small as Lemon up to 1200-1500 calories a day (pretty impressive, given that's as much as many adults who are five times Lemon's size eat!). 

Dr. Powers pro tip: the strategy works on spouses, too!  Give it a try and let me know how that works out for you...

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