My paediatric placement was really enjoyable. I saw mostly young babies with plagiocephaly, developmental delay, and some older kids with DCD. Most of my patients (and their parents) were all really nice. The majority of the kids were well behaved. The occasional baby would be tired or hungry and get easily upset, but that wasn’t the worst thing to deal with. About half way through my prac I had to treat a really difficult child.
Throughout the prac there were the occasional older children who would have short attention spans or not be able to follow many complex commands, but I soon developed strategies to deal with that. There was one child, however, that I struggled to deal with. I think he was about 4 or 5 years old. He had delayed gross motor skills and poor core strength and functional balance. But worse of all he was extremely bad behaved.
This kid was simply uncontrollable. He was bouncing off the balls, wouldn’t follow the simplest of commands, and if you got close to him he would slap, punch, kick, or headbutt you. Towards the end of the session he even started forming a big mouthful of spit and threatened to spit at me and my supervisor. I know exactly what I wanted to do with this kid, however, I don’t think it would’ve gone down too well with my supervisor. So I had to use more politically correct strategies to deal with this little bundle of joy.
I did actually feel sorry for this kid though. The child came from a very difficult family situation. His father wasn’t really around, and his mother worked away most of the time. He lived with his grandfather, who didn’t pay a huge amount of attention to him. The grandfather would bring him to the appointments, but sit outside during the session not interested what was going on with his grandson.
My supervisor was really helpful. She has many years experience and knew how to deal with this kid. I tried my best, but I don’t think I was very effective. My supervisor later said that when a child is like that you can only do your best and sometimes you cannot avoid it and their bad behaviour may cause a session to simply not be very productive. It is not your fault if you are in that situation and you do your best to overcome it.
I was glad to be put in that situation because I learned a lot from trying to deal with it, as well as seeing my supervisor pulling out some tricks from her years of experience. One thing she did for example, was to bend down to his level, grab hold of his shoulder with one hand and point her finger with the other, stare him down with her face right next to his and speak to him in a strong voice. I seriously thought that she was going to get spat on. But it worked. He did what she said when she did that. This was one of the only commands he actually listened to throughout the session. I gained several ideas from this experience that I will be sure to use in the future when I am in similar situations. Has anyone else been in a similar situation while on paeds or any other placement? If so, were there any strategies you used or learnt?
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3 comments:
I had a paeds placement and encountered a number of children very similar to the one you're describing. I agree they can be very 'challenging' and it can be difficult to utilise the 'politically correct' management strategies in order to provide an effective treatment. One of the tricks that I learnt from my supervisor was to engage a sibling or the parent in the game or the exercise that you wanted to do with the child whilst ignoring their disruptive behaviour. 9/10 in the end once the child realised they were getting no attention from either their parent or us the game or exercise was much more intresting and they were very happy to comply. While this was very effecyive in most cases there will always be that 'one kid' that will not do anything that you request and in those cases i think you just need to make do with the best you can.
Hey Patton,
I had a similar experience with a disobedient child on my paeds placement too. I was treating a young boy with cystic fibrosis twice a day. Once in the morning for airway clearance and once in the afternoon for general cardiovascular fitness/ exercise. He was usually quite compliant with the airway clearance session but as soon as we got to the gym for "sport" he would go crazy. Each session I went to I'd try to think of exciting new games to get him interested and keep him puffing but he'd just go completely off track and sulk when I would try to enforce the rules of a game. My supervisor suggested letting him come up with an game/ dictate the rules, as long as the game was "strenuous" enough for him to get an adequate workout. This was really quite effective. Though it did my head in letting him change the rules every two seconds (rules that were clearly not fair and did not show any elements of appropriate sharing/ social behvaiours) we managed to get a decent treatment session out of him! The kids might not have any physio knowledge (or respect authority or abide by rules/ the law) but they can definately be creative and have some control over their physiotherapy!
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