How do I discipline my 4 year old who has been diagnosed with shaken baby syndrome, low vision and juvenile arthritis?

I know he understands the word "no" and when i tell him to stop doing something. He is only developmentally around the age of 6 months.But he has been chewing on his left hand causing it to crack and peel constantly. Along with scratching his right palm causing it to callus,crack, bleed, scab and is always peeling. He has taken chunks of skin off in the past and I'm concerned it will never fully heal and could possibly become infected. I've tried covering it and he pulls the cover off, I've put ointment on it and put his hand brace on because he cant get the brace off but when i take the brace off to let his hand get air he goes straight to scratching it again.

Topics: Behavior
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Posted by Amber Bobnar on Apr 16, 2015 - 10:32pm

I think there's a difference between discipline and behavior when it comes to kids who are cognitively delayed, especially when they are displaying self injurious behaviors.

You can check out this article on addressing behaviors: http://www.wonderbaby.org/articles/self-injurious-behaviors

But it also sounds like this might be a response to pain or discomfort that he's having from the juvenile arthritis. What do you think? I don't know if there are ways to address the pain with medications (if he is having pain), but it might just be that this is his way of trying to deal with discomfort. You could try to teach him other outlets (like maybe give him a noise making toy that he can squeeze when he's uncomfortable?), but the best solution may be to cover up his hands... and hope that the behavior passes.

Posted by miranda_hughes on Apr 16, 2015 - 10:32pm

You are correct I would like to modify his behavior more than discipline him. That was my mistake I didn't know what word to use. My mother brought that to my attention today while we were discussing this. He does go through pain due to his arthritis but he is on medication for it. typically he seems fine and not in pain but occasionally he will show signs of pain. I don't think the scratching is due to pain or discomfort but I may be wrong. I've given him toys to keep him entertained so he doesn't begin to scratch but that never last long. It seems like every time i turn around hes scratching.

Posted by Amber Bobnar on Apr 17, 2015 - 10:33pm

If you can rule out pain or discomfort, then I agree with you about looking at this as a behavior. Do you have access to a behavior therapist? They can help you come up with a plan where you might reward him for the "approved" behavior (which I guess would be not scratching).

Another thing to think about is what is he getting out of it? My son used to bite people when he was younger. Hard! But he seemed to enjoy the reaction he got out of us. We would yell and fuss and he would laugh. I decided the best way to "punish" him for biting was to give him the opposite reaction - I would just sit him on the floor on his own and walk away quietly. He's always hated being ignored and this would really upset him. He pretty soon thereafter stopped biting. Well, he stopped biting me, but he kept biting his dad because he still yelled and made a fuss about it. ;)

Can you think of something that your son doesn't like (something like being ignored which is easy to do and not harmful) that you could do when he is scratching so that he can understand that scratching leads to something negative?

Posted by Amber Bobnar on May 17, 2015 - 10:33pm

I wonder if this could help? http://www.hatchthatidea.com/node/1414?q_subdomain=random-ideas

"A protective hand glove for children who chew their hands and fingers on a regular basis. Offers tactile sensory feedback with bumpy texture while providing full protection against biting and jaw pressure. Glove has breathable pannel to prevent hand sweating and bacteria growth, machine wash and dry, comes in a variety of styles, colors and superhero prints to coordinate with daily outfits."