Everyone said that spring arrives in Missoula on Mother's Day weekend. And they were right. Over the course of a few days, we witnessed a big blossomy bang.
Heath had been patiently tracking the progress of his seeds -- now we could put them outside.
Our garden, which was covered with snow when we moved in, turned out to be full of tulips and beautiful perennials.
Heath had a few new beginnings of his own this month, exciting ones! Pedaling a push trike, drinking independently, and starting to use a rolling pin with both hands.
Other things weren't caught on camera, like feeding himself 11 bites of food out of the blue this morning! After months and weeks of saying, "No, Mama" whenever I offered him the spoon.
Heath's developmental leaps are inevitably surprising, sudden, a little bit surreal. What just happened in there? I always wonder. We might have encouraged or demonstrated an action over and over for a long time with no apparent response from Heath other than tolerance of our moving his limbs and digits around. Sometimes he recoils strongly from our help, as if to say "I don't WANT to drink from a cup on my own! Don't make me!" And then one day, one moment, he makes the choice to attempt something entirely on his own, for reasons invisible to us yet urgent to him. At those times, he makes the greatest leaps into new territory, more or less without us.
After two years of watching therapists work with Heath, I'm still fascinated by the enormous role played by his own motivation, which is unpredictable, mysterious, and rarely focused on what we think might be important to work on today. The best therapists know how to flow through a program that challenges Heath in key areas (balance, muscle weakness, muscle coordination, conscious control of muscle tone, and learning new motor patterns, plans, and habits) while responding to his own sense of what is important to master, as well as his need to experience fun, variety, respectful relationships, and success. We are grateful to have found Ed and Paula in Missoula, two good-hearted people who give a great deal of thought and energy to planning their sessions with Heath while keeping him laughing, or at least engaged, interweaving and alternating hard work with delightful play, songs, and silliness.
Their work and ours guiding Heath through the movements of crawling, squatting, standing, kneeling, walking, eating, etc., builds on preexisting neuromotor programs designed to unfold like a flower in all developing children. For Heath, these built-in developmental imperatives are fainter and more scattered due to his injury, which creates neuronal communication challenges akin to static on a telephone line. By assisting him over and over, we can reinforce a pattern he can access later when he is ready to try something out for himself. If an action is too hard for him, he will abandon the effort and might not try again on his own until weeks or months later. If it is within his reach, he will try again and again, as he does these days trying to write a letter "M", press cookie cutters into play-dough, put on his hat, or walk while we hold one of his elbows.
What I have learned is that Heath and we are involved in a dance. We lead, then he leads. We attempt to guide, inspire, demonstrate, and challenge in the most entertaining and engaging way possible. And then we step back and he shows us where he wants to go. He is influenced by what we show him is possible. And we are influenced by his intelligence about how all that new territory looks to him -- and how he intends to get there on his own, at the time and place of his choosing. This dance requires that we trust Heath to get where he's going, just as parents of typical kids can trust that theirs will walk and talk. His timetable will be different and his ways and means will vary, but the longer I know Heath the more I am convinced that he knows at least as much as we do about the proper course of his own learning and development.
Maybe because of this, I have given up bribery. It used to be six chocolate chips for six crawling laps across the dining room. Do this and you'll get that. And then I noticed that his intrinsic motivation to pursue crawling was flagging. I was sending him the message, "Crawling honks, therefore I have to give you goodies to get you to do it." I wasn't seeing him flop down to give army crawling his best shot anymore. What good was that?
Reading Alfie Kohn's exhaustively researched book Punished by Rewards made me realize I was treating Heath like a lab rat. Which is not surprising really, since we have been deploying pop behaviorism techniques on children and workers since before B.F. Skinner came along -- he just made it seem more scientific. But Kohn trots out study after study showing what every bored and unmotivated office drone knows: that systems of reward and punishment may bring short term compliance but fail consistently over the long term at bringing out the very best in people -- the most sincerely motivated good behavior, the most passionate learning, the most brilliant creativity, or the most inspired productivity. What people want are not rewards, but autonomy, choice, meaningful activity, and collaboration.
How to discuss all this with a two-year old? Hmmmm. Back to the dance. On the therapy side, we have to explain to him as best we can and as respectfully as possible that activity x or y, which may tire and annoy him, is important to his own goals of getting around on his own. We need to offer him choices whenever possible about how to undertake that activity and even when to let it drop. And we need to be alert to what is meaningful to him on a given day and help him achieve it on his own if possible. We have to let his inner reward system of pure satisfaction work for him. Rather than overwhelming him with praise every time he gets the peg in the hole, we have to sometimes allow a silence in which he can hear his own little fireworks bursts of pride inside. Because that's really where it's at.
Ultimately, it's up to us to put him through his paces as best we can, and up to Heath to make the big moves. No chocolate chip in the world is big or tasty enough to compete with his own primal desire to change and grow. We can trust that desire, we can cheer for it, we can encourage it when it falters, but we aren't the source of it. And he doesn't need us to be. All we can do is find honest ways to connect with his intrinsic desire to crawl (or eat with a spoon or break out of his walker one day), desires which may seem latent at first, but in the end turn out to be more powerful than any extrinsic motivator we could devise.
And maybe we save a piece of our relationship in the process. I worry that in addition to being Heath's primal source of love and security I am also his Olympic coach. It is my duty not to leave his body to its own devices during these crucial early years of ultra-neuroplasticity and rapid growth and development. He will go further with guidance, habit-building, therapy, and strengthening that he would without these things. So, I need him to comply.
If I rely on blatant manipulation as a technique to gain compliance for a week, that's one thing. But if I do it for years, I fear we will pay a price in terms of lost trust and respect. Maybe we won't get as many reps done tomorrow without M&Ms as we will with truthful talk, but maybe Heath's long term enjoyment of exercise and exceeding his limits will be greater. Maybe one day he will surprise me, as he did this morning feeding himself bite after bite of cereal, by saying, "Hey Mom! Let's do weight training!" Or, "I think I'm going to learn to ski." Or whatever he sees on the horizon as his own next possible adventure.
I hope we're making the right call where all this is concerned. Parenting is a balancing act like no other. Sometimes I think there is a right answer: either we're pushing him too hard or we're not pushing him hard enough to reach his physical potential. Other times I think there is no either/or, no way to measure a "best" outcome that doesn't include a sense of rightness, love, trust and mutual respect.
Happily, trusting Heath to forge ahead with his big spirit is as easy as trusting the tulips to pop up in May. They do it because they need to, they want to, and that's what they're made for. Same with parenting (and grandparenting! ) this incredible boy. It just happens. We keep re-orienting, guided by bigger things in turn. Somehow, I'm fairly certain, it all works.
its got wonderful insight that showed me more on what i was thinking unconsciously than all the books i can ever read. thanks
Posted by: melissa aka equidae | May 31, 2011 at 04:00 AM
Jenny.....you write so beautifully....it's such a gift to be able to read this blog and follow Heath's incredible progress....thank-you! Marilyn Foster
Posted by: Marilyn Foster | May 31, 2011 at 10:26 AM
This is a hugely important topic and I loved the post. With vision therapy, rewards helped kickstart things for Stella. I felt that as she was turning two years old and just starting therapy, it was unfair to expect most of these tough activities to be inherently rewarding. They were painful to her eyes (at least very uncomfortable and extremely challenging both emotionally and physically) with hardly a trace of immediate pay-off in visual improvement (in fact sometimes it gets worse initially, with more double vision, strain, headaches, etc). And she didn't understand why we were doing them though I tried to explain. (To her, she could see fine. It's what she knew.) I loved the video you posted on Facebook about Aimee Mullins and her grueling PT (that she didn't find rewarding) and how that doctor re-framed those giant rubber bands by saying "You're a strong, powerful little girl. I'll give you $100 when you break one of those bands." There was an artificial incentive but more important than the reward was the message he sent with it. I think that the problem is, as you suggest, continual/constant reliance on meaningless rewards. Special, well positioned rewards here and there in life, presented thoughtfully (unexpectedly?) and with real purpose, may have a place, and could be powerful messages as happened for Aimee. Sometimes we parents jump to them too quickly to ease our own anxiety, not theirs! I may have done that with potty training due to my own impatience and mental timeline--oops! Sounds like you regard the chocolate chips for crawling the same way as he did have some inherent motivation and was simply going at his own pace. Bravo for being so incredibly self-aware and in tune with Heath. You are really a role model to me in these areas. Thanks for sharing.
Posted by: Amber | June 11, 2011 at 02:47 PM
Hi there, I thought I left a comment before (it was too long anyway) but apparently it got lost in the interwebs. Just wanted to say I agree. Small meaningless rewards are out! The only kind that make sense is the one Aimee Mullins talked about, when she was called a strong little girl and that she'd earn $100 if she broke those bands she hated. I used rewards for VT at first with Stella, because there was really nothing intrinsically rewarding about it at first--it actually just made her eyes feel strained. Now they're not necessary. I definitely used them too much for potty training--because I was trying to move on a timeline for me/preschool instead of letting her go at her own intrinsically motivated pace (oops).... thanks again.
Posted by: Amber | June 22, 2011 at 02:53 PM
Jenny.....you write so beautifully!
Posted by: jeu roulette gratuit | January 31, 2012 at 11:25 AM