How fireworks triggered a slew of novel bedtime fears and behaviours

Halloween 2020, my daughter is a little over three years old and we are still in the midst of the COVID-19 pandemic. It is nearing the end of November as I write this, and we have been facing an unprecedented bedtime and nighttime challenge everyday since October 31. My daughter has expressed being scared on an almost nightly basis which has interfered with our bedtime routine and has included multiple night wakings. In this post, I discuss the factors contributing to these events, the strategies I have employed and how I plan to continue.

My daughter’s sleep state prior to Halloween 2020: ever since we sleep trained our daughter at 7 months using a supported crying method, she has never woken up during the night (apart from her last night feeding which stopped around 9 months). I mean really. I can count on one hand the number of times she has woken during the night: zero. Additionally, she is an excellent napper and still naps 1.5-2 hours a day. She loves her sleep. It is clear to me that she uses her time in her dark, rain-noise-filled room to reset and decompress from all the anxiety-inducing events of the day. She often sings and chats while going to sleep and upon waking. Even when she wakes, she does not come out of her room but waits until I come to get her. I have always been very respectful of her sleep schedule adjusting all factors of our life to accommodate everyone’s sleep – i.e. no medical appointments, no visiting or driving or staying out past naptimes or bedtimes. I think this has contributed to her excellent sleep.

Vancouver is unique in Canada (and probably most places) in that it is traditional to set off personal fireworks on Halloween night. I had a very strong childhood fear of fireworks and Halloween. They were intertwined in a very scary way. Halloween has a reputation for teenagers and young adults to behave stupidly. And by stupidly, I mean drink an excessive amount of alcohol and use explosives (fireworks). Some of the stupid teenager behaviour on Halloween includes tying fireworks to dog’s tails, throwing fireworks out the window of moving cars at random pedestrians, pushing fireworks through mail slots of front doors, and blowing off their own fingers. This, combined with people dressed in costumes that included masks (of which I already had a deep-seated fear), made Halloween a nightmare for me as a child. And frankly, I still hate it. But, upon my psychologist’s encouraging, last year (2019) I took my daughter (then 2 years old) trick-or-treating in our exceptionally safe and kid-friendly neighbourhood.

Fast forward to this year, and due to the pandemic, we did not go out trick-or-treating. But the pandemic did not stop the fireworks (and subsequent three-fold increase in calls to firefighters that night). We were able to see a few fireworks in the sky from inside our condo. I tried to point them out to my daughter, but I was never quite sure if she saw them or just heard them. That night, after our usual 5-minute bedtime routine, my daughter said she was scared for the first time. I asked what she feared, and she said fireworks. I told her they would be over soon (lies), and they were a loud noise. Fireworks are outside and will not come inside. I tried to leave but she started sobbing and I could hear the real fear in her cries. I held her as she cried and pondered what to do. I decided I would sing extra songs. I sang for a while and hoped the fireworks would die down. Eventually, I told her I had to use the bathroom and would come back again afterwards. I left and she started sobbing. I did a couple of quick jobs to get myself more comfortable for what was looking like a long night. I held her for another 45 minutes singing continuously. She finally became so exhausted that she wiggled out of my arms and I tucked her in, and she fell asleep. She woke up again in the night and started crying because she was scared. Repeat my singing and eventually I got her back to sleep.

On subsequent nights, her behaviour included saying:

  • “I’m feeling scared” on repeat.
  • “Fireworks scare me”
  • “When am I going to die?”
  • “When will you die?”
  • “When will Daddy die”
  • “I’m feeling scared of dying”
  • “Are Gammie and Grandpa okay?”
  • “Keep the door open”
  • “Shut the door, the light is bothering my eyes”
  • “I’m cold”
  • “Don’t put that blanket on me”
  • “I need to pee”
  • “I need a drink”
  • “I need cream on my chin”
  • “I need a blanket under the door [to block the light]”
  • “I need the blanket away from the door [to see the light]”
  • “Is it time to wake up?”

She also started new behaviours during bedtime, naptime and in the middle of the night:

  • Opening her door
  • Shutting her door
  • Slithering down the hallway
  • Running around her room
  • Adjusting the blanket under her door (that had been used up until this point to block the light coming into her room)

The most prevalent fear that she raised was about death and dying. Rewind to August. I found a bird that had died on our balcony and instead of disposing of it before she woke from her nap as per my original plan, I decided to show her the dead bird. I had just read about how we over-protect children from natural occurrences of death and that I should use the opportunity to explore the beauty of the bird, try to look up what type of bird it is and provide the opportunity to experience a “removed” death. After the bird, we also read the book Lifetimes: A Beautiful Way to Explain Life and Death to Children by Bryan Mellonie. At that time, she had asked about three times when Mommy, Daddy, [herself], Gammie and Grandpa would die. I used the Lifetimes wording and descriptions and kept it pretty vague but did assure her that she would live a long life (since even if she doesn’t, she wouldn’t know because she’d be dead, so no point in not providing that reassurance is my thought).

Although I had a lot of childhood fears, I never had an explicit fear of death. I feared being murdered or bad guys murdering/attacking my family, but it was the attack that I feared, not the death outcome. I feared floods and fires (and I guess the aftermath of potentially not escaping and dying), but I never thought of death in an isolated situation as something fearful so when my daughter expressed that fear almost exclusively, I did not know what to say! Most articles that describe children’s bedtime fears mention the dark or monsters; death doesn’t get a mention in most discussions of toddler/preschooler fears. Even adults fear death. It is such an existential fear and difficult to discuss without possibly making the fear worse. She does not know what death really is, so it is unclear what she actually fears. The problem I found is that if I ask her what she fears, she says, “you [Mommy] tell me”. But I do not want to put additional thoughts or ideas into her mind. For example, if I talk about death as something like sleeping peacefully, then she may become scared that she will die when she sleeps and never wake up! I have discovered that it is difficult to discuss death with a 3-year-old without making the fear worse or presenting new fearful concepts.

Back in the present, I decided that I was not going to do any kind of ignoring strategies for her night wakings as I think these methods do not address the root problem and imply that being scared is a bad behaviour to be extinguished. I also think it would be terrible if someone I cared about left me alone with my fears when they could have offered comfort! So, I tried a bunch of strategies to help my daughter cope, including:

  1. Focus on the next point of connection: “I’ll see you in the morning for breakfast. We will have yummy strawberries.” (From Dr. Gordon Neufeld’s pandemic talk.)
  2. Distract her with pleasant thoughts, “You love going on big adventures. You will think about swinging, biking and going down the slide. Weeeeee. That’s so much fun.”
  3. Sooth with singing.
  4. Sooth and distract by singing songs that she could also sing
  5. Sooth by holding/rocking/snuggling
  6. Read the book The Invisible String by Patrice Karst and describe the connection of love between our hearts even when we are in different rooms.
  7. Assure her that no one (that she mentioned) will die soon, and we will all live a long life. I know this goes against most recommendations about fears. You should not reassure something that is not true. But I have yet to read about recommendations for discussing death with a behaviourally inhibited 3-year-old! Although I would try to get into more nuance with an older child, I decided that at bedtime and in the middle of the night I am going to lie a little bit since it is highly unlikely that any of my daughter’s immediate family are going to die soon. When I read the Lifetimes book, there is discussion of short and long lifetimes so my daughter is not completely shielded from that idea, but I decided that 4 am is not the time to dwell on specifics!
  8. I told her it was my job as her Special Big Person to hold on to her “Scared” (I got this idea from Jennifer Lapointe’s book Discipline Without Damage). I told her to give me her Scared and I would take it away. She gave it to me with her hand and then I ate it with a munching sound. My husband thought this would be even more scary but I came up with eating thing at 2 am. In hindsight, I might not do the eating thing, but in the end, my daughter seemed to really like this strategy and has since asked me to, “eat my Scared”.
  9. Fill her head with kisses (Dr. Jennifer Lapointe).
  10. Fill her Lovey with kisses and tell her Lovey to give those kisses to my daughter in the night.
  11. My husband told her that her animal buddies were her protectors in the night (he read about that strategy online). Unfortunately, our daughter replied, “they [buddies] are not real.” So, that one kind of fizzled out!

I think all the above strategies helped somewhat, but the most consistently helpful methods in order were: singing (strategies 3 and 4), filling her and her Lovey with kisses (strategies 9 and 10) and “eating her Scared” (strategy 8). Since trying these strategies, my mom sent me this article about childhood fears of death from Psychology Today. There is no research evidence explicitly cited so it seems to be just an opinion piece, but it validated me assuring my daughter that we would all live long lives, despite not actually knowing if that is true [more info from this article]!

Although the fireworks seemed to trigger this period of nighttime fearfulness, there are a few other factors that have contributed to this perfect storm:

  1. I have had new health issues over the past 3 months that have made me less active and just plain “different” from before.
  2. Just prior to Halloween, I had started talking to my daughter about not wearing her diaper to sleep anymore and in the middle of November, I wrote a story to help transition her from diapers to undies. So, although I didn’t try to push the situation after the fears started, she ended up using the potty while she was having all these fearful night wakings. Eventually, some of the fearful night wakings transitioned to just potty wake-ups that still required tucking back in to bed.
  3. Her aunt broke her ankle in the summer and that affected our usual schedule.
  4. Her grandpa had a knee replacement surgery the day before Halloween and we were not able to see Gammie and Grandpa as he recovered.
  5. Just after Halloween, new health orders came in restricting our bubble (which had included Gammie and Grandpa) to household members, which significantly altered our schedule.
Update (Dec 12, 2020)

We have now had two sequential nights without night wakings! It has been amazing. Once all the night wakings had transitioned to potty wake-ups without fear, I talked to my daughter about using the potty and going back to her bed and under her covers to stay warm and that she did not need to call me. I had little hope that this would work, but lo and behold, she did it! I have no idea if she is getting up at night and tucking herself back in or if she is sleeping all the way through. It is too early to say that this is our new nighttime but it sure is nice to have this reprieve.

An additional strategy I recently instigated was to do a double tuck-in at bedtime. I do my usual singing routine and first tuck-in, then promise to come back for a second tuck-in and last song after I do my bedtime jobs. This seems to work well in keeping her in her room and letting me get my own tasks done while giving her the security that I am not leaving her alone at night. There have been two instances in which she has fallen asleep prior to the second tuck-in, but other than that she is awake and happy to hear her last song and expresses no fears or concerns before falling asleep on her own.

Childhood fear of Death and Worry Time

One of the strategies mentioned in this article is a 10-minute Worry Time during the day where the child is encouraged to worry for 10 minutes and then stop. I have heard of this strategy as an adult and had a counsellor recommend it with the addition of an elastic band on my wrist that I would snap after the 10 minutes to “snap” out of the worry state. However, I did not find the technique particularly useful. It is incredibly hard to stop your mind from worrying once it starts. I tried it for a few days but found the worry (in my case it was also a very specific worry, not generalized) kept popping into my head and it was incredibly difficult (if not impossible) to stop the worry with this technique.

The technique reminds me of the concept of writing down your thoughts before bedtime, so your brain does not keep thinking about them. Both my dad and I have used this technique successfully for mundane thoughts that keep you awake, “I don’t want to forget milk on the grocery list.”, “I need to set up a meeting with Bob tomorrow”. I have noticed that if I take the time to get out of bed and write down the thought, my brain relaxes and stops thinking about it. However, I have not had the same success with worrying/anxious thoughts. Writing them down does not seem to stop them from making my brain “buzz”. Since I have only experienced using this technique as an adult, I am not sure how much easier/more difficult it would be for a 3-year-old to successfully offload worries during a Worry Time such that those worries would not come back again in the night. I feel like this technique has the potential to make the situation worse by creating more worry dwelling time; I am hesitant to start it without good evidence that it will be helpful and not hurtful. For me, the jury is still out on Worry Time.

Ok, I slipped this post in here because my life revolved around these night wakings for the past month, but I still plan to discuss some of the brave stories in my next post.

behaviorally inhibited temperament exposure ladder

My struggle with balancing anxiety treatment and life

Sometimes dealing with anxiety (or a behaviorally inhibited temperament) can feel like a losing battle. You finally address one fear and five more pop up. There are many days when I wonder, “how much fear-facing is too much?” How should I weigh “encouraging bravery and working on fears” with “accepting my child as-is and building a positive, loving relationship”? Experts would say those two goals are the same and do not need to be balanced, especially when you look at the big picture of a person’s life. But every parent of an inhibited child knows that those two goals come into conflict daily. Crying, tantrums, resistance, and abject terror on your child’s face are just some of the possible outcomes of facing fears, even in controlled environments. These behaviours are physically and emotionally exhausting for both the caretaker and the child.

Facing fears is extremely hard. I often wonder how many psychologists and therapists have used cognitive behavioural therapy and exposure therapy to face their own worst fears? I first learned about this treatment when I used both therapies for a medical condition and associated phobia in my twenties. I spent 2 hours per day on meditation, mindfulness and thought records, and then worked on the exposure ladder. I chose each step and set the timeline and rewards. It was incredibly difficult and time-consuming. For the specific phobia, working through the exposure ladder was one of the hardest things I have ever done. I know the physical and emotional toll it takes to face a fear using these methods. This is one of the reasons why I balk at the idea of continuous and constant exposure for inhibited children.

I mentioned my daughter’s tendency to avoid busy play-gyms to the psychologist and she told me, “oh no, you can’t avoid play gyms. You need to go to them.” And I thought, why? I hate them too! They are loud and over-stimulating. Many of the children are poorly behaved with caregivers sitting on the sidelines with their faces in phones ignoring their child who is grabbing toys from anyone within reach. As the gym filled up with more and more children, my daughter stopped moving, looked at the door and walked towards it. I would have had to physically restrain her and have her cry to keep her in the gym (or reward her a lot!). Then, would I have to decide how long before we were “exposed” enough? I could set up an exposure ladder with rewards to achieve a cry-free extended play-gym experience. But is this worth it? I don’t know. I know that I do not like big groups of my peers at busy bars and pubs (the adult equivalent to play-gym?). I do not want to go to a party and make small talk for hours. I am happy and content with my life. I love being a mom and I am a good scientist. I like getting together with close friends. I like being with bigger groups of friends and family on special occasions. I got to “work” my friend’s wedding and I had a blast. I felt useful while still being in the hustle and bustle celebrating my friend’s big day without having to make small talk continuously. I help others and get a lot of joy out of my interests like baking and sewing. So why does my 22-month-old need to survive play gym?

The psychologist would probably agree that there needs to be balance, but when I read information about anxiety, there never seems to be a balance: the recommendation is exposure, exposure, exposure. And the research seems to support this. Researchers have shown that anxious rat pups (baby rats) exposed to novelty early in life became less anxious adult rats compared with control (unexposed) pups. A human child might be less inhibited as an adult with forced, continuous exposure therapy in early life, but at what cost? I do not think science and research has an answer for me. Those mother rats never had to endure tantrums from their exposed pups, and those rat pups did not cry when the researchers picked them up and removed them from their mom (or maybe they did!). And when they were adult rats, we have no idea if they still “loved” their mom and had a positive attachment to their mom. Unlike mother rats, human parents weigh the benefits and consequences to find a solution that works for their family. This might mean exposure, exposure, exposure. But it also might mean some exposure and some avoidance to make space for other non-fear related positive child-parent interactions because there are only so many hours in the day.

The bias underlying anxiety treatment (and the associated research) is that uninhibited, social traits are preferred over all other personality traits [more info]. As an introverted, inhibited, shy person, that slant feels wrong to me. Our strange existence in the pandemic has given me pause to reflect on anxiety treatment and exposure and I am still working towards finding a balance for my daughter and me. I found great success with the elevator exposure ladder, but would I want to do this every day for every fear? No. I am taking a page from Ross Greene’s book Raising Human Beings, and prioritizing my daughter’s fears. I do not need to tackle them all. She does not need to tackle them all.

In my next post I discuss behaviour modification and my mostly hate relationship with this ubiquitous parenting strategy.

The Good in Inhibited Children

After I wrote this post, I started reading an evidence-based book, The Orchid and the Dandelion by W. Thomas Boyce. The author weaves his personal family history with research findings related to inhibited (orchid) and uninhibited (dandelion) children. He creates a story that describes the challenges of having an inhibited temperament and the unique opportunities to nurture great beauty in the child. It is the first writing that I have come across that explicitly states research-backed positive traits of an “orchid” child. I will provide an update when I finish the book.

behaviorally inhibited temperament play-it-out re-enactment


In my previous post, I discussed some of the strategies that my partner and I used to help our daughter with specific aspects of her anxiety that were exhibited before 2 years of age. Most of those strategies were developed in response to her actions and were not based on any treatment or specific anxiety knowledge – just our best guess of how to cope in the moment! In this post, I will discuss one of our earliest “informed” strategies that is broadly applicable to general anxieties from the past, present and future and continues to have great impact in our daily life. I titled this strategy “play-it-out” and it is the manifestation of my husband’s and my interpretation of a few sections from the book The Whole Brain Child by Daniel Siegel and Tina Bryson.

The Whole Brain Child has wonderful information. The brain science is fascinating, and the “comic” descriptions of the various strategies were very useful. Of interest to my husband were the sections on storytelling to integrate the left and right sides of the brain (Chapter 2, Strategy 2) and on memory integration with events (Chapter 4, Strategies 6 and 7). Integrating the left and right sides of the brain works to link facts and details (left) with feelings and emotions (right). Through storytelling, the child names the event and is then better able to move towards taming the feelings for future related events. This strategy conveniently involves memory integration, in which we remember the event and associated feelings such that the feelings are explicitly connected to the event instead of floating around disconnected. Floating feelings can become attached to unrelated events, causing phobias and fears that, from an outsider’s perspective, appear to have no origin.

For example, a young child is bitten by a dog. The child cries and eventually recovers and the days and weeks (maybe months) pass. Eventually, the child fears cats, birds, dogs, and various animals. You might reassure her that the animals are friendly, safe, and more afraid of her than she is of them, but nothing you say seems to change her fear. What happened? The dog-biting event created a feeling of fear in the child. By effectively ignoring the event (i.e. allowing “time to heal all wounds” and “memory to fade”), the disconnected, floating fearful feelings attached themselves more broadly to many animals. No reassurances will fix the problem because the reassurance does not address the original dog-biting event. At this stage, a brave story and exposure ladder could be used to help the child face the fear. What could the parent have done differently to possibly prevent this phobia from developing in the first place? After the dog-biting event, the parent can talk to the child by describing the event and naming her feelings and experience. In the days and weeks that follow, the parent can help the child tell the story (if the child is verbal) and even re-enact it with stuffed animals. This creates a connection between the fear and hurt with that specific dog-biting event. If the dog was unfamiliar, then your child will probably never see the dog again and that will be that. If the dog was familiar, the child will still probably have some lingering fear about that dog in future situations because that dog really did bite her! She will need many positive interactions before she can “trust” the dog again. And of course, she may need more explicit instruction on how to safely interact with that dog (and all dogs). That is normal. But, hopefully, she will not develop a phobia of all dogs from the single dog-biting incident.

As you probably guessed, my daughter was that child that was bitten by a strange dog (without teeth!) when she was 12 months old. After the bite, she did not cry, there was no blood or cut and I did not think it hurt. I ignored the situation since she appeared to be fine and thought, “oh well, her memory will fade”. But I was wrong! She was terrified of dogs for the next 8 months and at 3 years old rarely pets a dog and has a look of terror on her face if a dog comes towards her. As soon as I read The Whole Brain Child, I knew I hadn’t handled the dog-biting event well! The problem is that I did wait long enough for the memory to fade so now I am not sure if there is any point in describing the original event as it would be completely unknown to my daughter. Just as predicted in the book, the feelings attached themselves to all dogs (luckily, they did not attach themselves to cats or birds – look out Goose, my daughter is coming for you!). Now I am faced with a phobia treatment with a story and exposure ladder. However, her dog fear is low on my fear-conquering priorities, so it is on the back burner for now.

After discussing the left-right brain integration and memory integration, my husband implemented our new “play-it-out” strategy to link our daughter’s emotion with an event. For example, our very active daughter liked to spin in our small living room with hardwood flooring and various pieces of furniture. Inevitably, she would fall and impact something and burst into hysterical crying. I held her and witnessed the tears and provided words for the experience, “ouch, you had a tumble. That hurt. You are sad. It’s ok to be sad and cry.” Eventually, she stopped crying and my husband used her large stuffed penguin (which was about her size!) to re-enact the event. He showed her with the penguin how she fell (trip, face-plant, etc.), what she hit (foot stool) and where on her body she hit (head). He repeated the process as many times as she asked. She was enthralled after the first time! Often, my husband re-enacted the event himself and then our daughter re-enacted the re-enactment at slow speed, complete with a fake fall! We did this repeatedly. Sometimes, we did not see the event and could not re-enact it accurately. Instead, we first asked her what part on her body hurt. She might point to her knee and then we guessed what she impacted “might this have happened? Or maybe you hit this?” She might grunt (which was her sound for yes). And then we re-enacted what we thought happened. Now that she is 3, she often points or describes which part on her body is hurt and then she will sob into my chest and mumble “show [me] what happened”. The re-enactment is now part of her healing process! She stops crying almost immediately when Daddy re-enacts the event. Not only are we integrating events, feelings, facts and memories, we are also changing the unknown into the known, the exact root fear of people with anxiety! So much of what is scary about falling is not knowing how or why it happened and then not knowing how to prevent it in the future!

The next aspect of the play-it-out method is performing oral stories and plays to address previous anxiety-inducing incidents (like a dog-biting event!). After nap time, I used her stuffed animals to ask her about her morning. Usually, she did not describe anything, so the animals asked me, and I provided a few details. The animals continued to probe but, unfortunately, my daughter’s language is a little delayed and she just did not have the words, so I typically recounted the incident in as factual language as possible. The animals asked questions and expressed feelings and concerns. For the first storytelling, the animals acted as an interested audience to the story and then transitioned into play. For retellings of the story, the animals acted out an analogous story and showed the expected/desired behaviour with possible ideas and solutions that my daughter could use the next time she found herself in that situation.

For example, during one of our first days at a parent and tot forest school when my daughter was 2 years old, another child walked up to my daughter and pushed her over. It happened fast. My daughter and I were both shocked. I was so busy trying to assess the group of kids and help my daughter stand near the group without freezing that I was not anticipating a direct knock-out! My daughter burst into tears and I provided comfort and eventually we carried on with the class. That day after nap, I began my storytelling. My daughter was visibly upset about the situation. We talked about how the other child was having a hard time that day and she was feeling mad. It was wrong of her to push. It was surprising and unexpected. We moved on to play as I did not want her to dwell on the event and I hadn’t actually thought of what the best strategy was moving forward! Even Mommies need time to think. In subsequent retellings, the animals suggested that my daughter say, “no” or “ouch! That hurt! Don’t push!” (I would have been lucky to have her make any sound directed towards another child, so it was a bit of stretch to suggest speaking. I was hoping for the “no”). For my part, I decided that I needed to be more upfront with the other child. A week later, we attended the next class and as the other child made another beeline to my daughter, I stepped forward and said (in the most enthusiastic, cheerful voice I could muster), “Hello, Jill, I like your whistle.” This preemptive invitation to a friendly interaction paid off. The child stopped moving towards us and looked at her whistle. Then I pointed out my daughter’s whistle. Then, the teacher started talking and we avoided a negative interaction. After a few more classes with forced Mommy-induced positive interactions, the other child had settled into forest school and I no longer needed to head her off at the pass! We retold the pushing story almost daily for weeks (usually from my daughter’s prompt). But by the end of forest school, my daughter talked about this other child in a positive way and included her in our “forest school play” at home. The other child was now referred to as a friend who rolled down hills and was a highlight of our forest school experience. The play-it-out method not only integrated her memory and feelings with the single pushing event but eventually, allowed my daughter to think more fondly of this child as we talked about her many positive attributes in our stories.

Another example is when my daughter was afraid of her little cousin who had learned to crawl! From an adult’s perspective, it was a funny scene: my 18 month old 80th percentile-size toddler slowly backing away and saying “no” with a sheer look of terror on her face from an army-crawling 10 month old 10th percentile-size baby. The little Crawler was desperate to get closer and touch my daughter and my daughter would repeatedly say “no” and fall into my lap and scramble up my body to get away from the little Crawler. My daughter could not focus on any activity if the Crawler was in the room. The only time she appeared to feel safe was in the highchair where the Crawler could not reach her. I used the animals to re-create the situation, and the animals came up with different ideas to cope with the little Crawler, like climbing onto the couch, giving the Crawler a toy, or having a snuggle with Mommy. After performing this play many times, my daughter started giving the Crawler toys, unprompted! It was amazing. My daughter still had great fears and concern about her little cousin. But, as we talked about more ideas (like Mommy will make sure everyone has food, since my daughter would be in a panic that the Crawler would eat all her food) and helped each of them have positive interactions, their relationship has grown to have more and more positive interactions. Now that they are 3 and 2.25 years old, they both speak in their own limited language (which does not overlap that much!) and “argue” about everything like whether it is raining. Whatever choice one makes the other makes the opposite, regardless of the weather or the truth. The little cousin always offers help when my daughter is upset and although my daughter still refuses that help, she occasionally offers hugs to her cousin when she is hurt!

In my next post I will discuss my struggle with balancing anxiety treatment and fears with life enjoyment.

behaviorally inhibited temperament

Seven strategies to use with young fearful children

As I witnessed the various atypical behaviours from my daughter (a selection of which are listed in the previous post), my partner and I started developing solutions. We fine-tuned our strategies as we read more articles and books. Here are some of the most successful solutions that we used from when our daughter was 7 months to the present time. 

  1. Our basic “discipline” guidelines and strategies came from reading Peaceful Parent, Happy Kids by Dr. Laura Markham. This positive parenting method has nothing to do with anxiety, but we found it a useful approach for coping with the regular trials of parenting (conflicts!). Markham describes an approach to discipline called “Empathic Limits”. In brief, discipline starts from a place of connection or attachment between parent and child [more info]. Then, the parent sets and enforces empathic limits using these steps:
    • Get down to the child’s level (with eye contact or physical touch)
    • Join with the child, “It looks like you’re having fun throwing sand”
    • State your concern, “I’m concerned someone is going to get hurt”
    • Use calm, kind, empathetic words as you set the limit, “I do not want other people getting hurt with sand, so let’s find a different way for you to use the sand now.”
    • Acknowledge her point of view as you set the limit, “It’s hard to stop what you are doing. But it’s time to find something else to do.”
    • Whenever possible, offer a choice, “Do you want to drive the truck through the sand or play on the slide now?”
    • If needed, calmly enforce an action, “I see you’re having difficulty safely playing in the sand where our friends are playing too. We are leaving the park now. We can try again tomorrow.” (aka “bring on the crying!”)
  2. For the long period of time when my daughter would “freeze” on the sidewalk and stare at another person until she burst out crying, I tried to “catch” her before the freeze by touching, talking and picking her up to comfort. Some people might think that this is rescuing behaviour which can actually make anxiety worse in the long run, but I thought it was more important to prevent the “freeze” response. My goal was to stop her brain from entering the freeze/fight/flight state, in which her brain and body would be overwhelmed by stress. I wanted my touch, words and voice to still have some influence before her automatic primitive brain took control. In hindsight, this “catching before the freeze” could be an early rung of an exposure ladder for an eventual goal of greeting our neighbours. Each step of an exposure ladder requires the anxious person to control their behaviour and commit to the step. If their brain is overwhelmed by stress and in a fight/flight/freeze, they are not in control. At 3 years old (and under pandemic conditions), my daughter rarely enters the freeze/fight/flight response. She will say, “no” and be resistant to novelty but she typically will not become paralyzed with fear anymore.
  3. A second strategy we employed for passing people on the sidewalk was to hold my daughter’s hand while we passed someone and label the person as a “kind neighbour out for a walk like us”. Usually, she did not like holding hands but when passing another person, holding my hand gave her the safety and comfort she needed to keep moving forward. The more times she walked by people without stopping (and freezing), the more times she experienced nothing bad happening! Although holding her hand does not directly address her fear of other people, the act of walking past people reinforces the tangential idea that there is no threat on the sidewalk. In addition, by labeling the person as a kind neighbour out for a walk, I created a familiar connection of someone being kind. This was a concept we had already celebrated when we first met a “kind doctor” when my daughter had a potential UTI. As well, it was a commonality between my daughter and the neighbour: they both like walking! At 3 years old, we still talk about neighbours walking in the neighbourhood and we practice brave talking.
  4. Bring a comfort toy (lovey) to all outings. I used this strategy based on our sleep consultant’s suggestion to provide an object that can be used to self-sooth for independent sleep and I was trying to create an attachment between my daughter and the object. It was so successful for sleep, comfort and soothing that I kept using it for general comfort for anxiety behaviours that typically occurred in social settings. Many people envision Charlie Brown’s Linus and his seemingly disgusting blanket being dragged around in perpetuity when they think of a child and her “lovey”. And in some respect, that’s true! (It’s good to have multiple loveys so they can be washed!) The lovey was one of the only things that allowed my daughter to calm when she escalated to fearful crying after freezing. Due to her sensory processing differences, my daughter dislikes being held, touched, hugged, etc., except on her terms, so having a lovey gave her comfort when hugging an adult was not helpful. At 3 years old, she brings a favourite toy outside and rarely uses it for comfort, but it is there if she wants it. She has loveys inside that still provide lots of comfort and joy. Maybe she will always have something soft to snuggle as she gets older. She may always need a lucky “rabbit’s foot” for comfort and I would rather she have a comfort object than to seek out food, cigarettes, drugs and alcohol to fill that need. Is Linus really so bad?
  5. Use a “brave” phrase to encourage my daughter to physically move forward: “1, 2, 3, go”. She would say this phrase at the top of a slide and then push herself forward, at the edge of a field to start running, and to continuing walking on the sidewalk before entering a “freeze” state. This was surprisingly successful. My partner and I would say the phrase and smile and encourage her to come forward and eventually she started saying it. I would even hear her whisper it and I could see her using it as a self-motivation tool. We have just recently returned to using mostly empty playgrounds since the pandemic and for the first few slides, I heard her counting to herself before pushing off! She no longer uses it for walking or running – she just walks and runs!
    • Note: Many inhibited children are also physically timid. When I described my daughter at almost 3 years old to the public health nurse, the nurse was shocked that she jumps, climbs, runs, rides a scooter, and rides a push bike. She was surprised my daughter was so physical. Since she was 7 months old, I have spent a lot of time at local parks and playgrounds every day. We were often the only ones there in the morning rain or shine. This allowed me to encourage physical bravery and physical movement without the inhibiting social factors of other children in busy playgrounds. She built confidence and had a natural interest in going fast, moving her body, and getting from one place to another. When we would go to busy playgrounds, she moved less, observed more and I had to “hover” much more because if she froze, she might suddenly let go of a ladder or swing or walk off a platform. But, as time went on and her confidence built, she was able to physically move past other people because she had enough muscle memory and confidence to keep her body moving even when her mind was in a state of stress.
  6. Lisa went through a few phases of being afraid of various slides and of sliding too fast. We showed her strategies of slowing herself down by using her hands and feet or by sliding on her tummy. As she went down the slide with a strategy, we would describe what she was doing and how she was controlling her speed. This gave her confidence that she was in control and she was safe. Eventually, she started sailing down the slides at full speed again!
  7. Modelling expected behaviour for child-to-child interactions. At busy play gyms or play spaces, I try to intervene with other children just prior to a physical altercation (which would then put my daughter in freeze mode). I spoke the words for my daughter saying things like, “No, my turn” or “I want to get out”, and I would describe to the other child what was happening, “She is using this toy. She is having a turn. You can have a turn when she is finished” or, “She is trying to get out of the house”. My daughter still has trouble speaking to others, but she is able to say these types of phrases to her cousin and she started turning her back to show kids at play gym that she was still using a toy. It’s not the ultimate behaviour I want, but they are steps in the right direction: remaining in control of her brain (staying out of the freeze state), using her body in a coordinated manner to express possession/turn-taking through body language, and starting to use appropriate phrases with another child in a low-anxiety setting.

You might notice that the outcome from some of these strategies does not meet your expectations for your child. You may feel strongly that they should not carry a stuffed animal when they are school-aged. And I completely understand why! Kids who are different are more likely to be teased and bullied at school. Unfortunately, your kid is who they are. You can try to change them into something else, but somewhere along the line that will probably backfire through rebellion or a poor parent-child relationship. However, you could prioritize weaning from a lovey at social settings like school and develop a story to help your child willingly leave the lovey at home. There are a few ideas to keep in mind when you think about your child’s behaviour and your expectations: are your expectations reasonable for your child’s age and developmental stage (i.e. make sure you are expecting typical or normal behaviour at the most, not advanced behaviour)? Are your expectations reasonable for your child’s inherent personality (given you may have an inhibited child, should you adjust your expectations)? If your child is not meeting many expectations, what are the priorities? Answering these questions may help you decide which goals are important and which ones you will let go of, for now.

In my next post, I will describe our play-it-out strategy that has evolved into a useful multi-purpose tool to help us process past events and prepare for the future.

Secure attachment and attachment parenting

Secure attachment between child and parent is now recognized as one of the most (if not the most) powerful and important influencing factor on a child’s wellbeing. Attachment has been tested by researchers using the “Strange Situation” experiment. The results of the experiment indicate whether the child is attached and how they are attached to the parent. In fact, the first thing our child psychologist did when she met my daughter and me was to conduct a version of the “Strange Situation” to confirm that we were attached. The psychologist said that there was no intervention for anxiety or any other problems that could be administered without attachment. Attachment appears to be generated through responsive parenting during infancy and babyhood. It is not simple to define exactly what behaviours the parent needs to exhibit to create attachment. There are many roads to having an attached child.

Attachment parenting is a parenting philosophy first proposed by Dr. William Sears with basic advice about how to parent with the goal of creating a secure attachment between parent and child. The problem is that the specific strategies are not all supported by research as necessarily creating secure attachment. Unfortunately, much of the advice can end up creating unnecessary stress on the parent-child relationship when the parent, for any reason, doesn’t follow the advice (i.e. vaginal delivery, breastfeeding, baby-wearing) and instead feels guilt, shame, and anxiety about not doing what Dr. Sears recommends. For some reason, this parenting philosophy seems to have created a militant following, such that there can be associated parent- (usually mother-) shaming if you don’t do attachment parenting. If you strongly support Dr. Sears’ attachment parenting philosophy and it has worked for you, that’s wonderful, but it is not the only way of creating a secure attachment with a child and for many parents and children, other strategies are more successful at creating a secure attachment and maintaining the parent’s mental health.

This article is a great summary of the differences between secure attachment and Attachment Parenting by developmental psychologist Dr. Divecha. This article is a summary of how a parent can create a secure attachment with their child and provides an interesting comparison between “secure attachment” and “bonding” (terms that are often incorrectly used interchangeably).

behaviorally inhibited temperament

Behaviours associated with an inhibited temperament

Now that we’ve seen a few tools in action (explanatory stories, brave stories, exposure ladders, routine chart), I am going to circle back around to talk about what motivated me to start investigating temperament and anxiety: my daughter’s behaviours in infancy. This ultimately led me to the brave tools that I am currently using.

From my daughter’s 3rd month of life, I knew her reactions to the environment were atypical. As time went on, I also knew she was not meeting social expectations/milestones for age-matched peers. There are plenty of books that advise parents not to worry about meeting milestones. Child development varies widely across children and a child who does not speak at two years might speak in full sentences by three without any intervention. On the other hand, delays in achieving milestones can indicate developmental issues that are best treated early or at least monitored by a healthcare professional. But how does a parent know when to wait and see and when to act? I started making a list of behaviours that were “different” when my daughter was around 18 months. There are too many behaviours to list all of them, but this is a representative sample. Each behaviour is not necessarily remarkable but taken together they paint a picture of a fearful child.

  • At 3 months Lisa was held by my friend. One week later, the same friend came over and upon seeing her, Lisa burst into tears; from that point forward, Lisa exhibited fear (crying) for all people other than mom and dad.
  • Lisa tracks/monitors every person in the room and is clearly concerned if someone “disappears” from view. Once she could make sounds, she called a person back when they left the room.
  • If a “stranger” (friend/acquaintance with child) comes into our house, Lisa sits in my lap, unable to do any activity.
  • At 5 months, Dad went on a five-day work trip. When he returned, Lisa cried and would not go to him. It took approximately 24-48 hours for her to warm to him again.
  • From 11-16 months, when we would walk down the street Lisa would fixedly stare at a stranger. After a couple minutes, she would burst into tears. She seemed paralyzed prior to crying.
  • At play gym if another child approaches or takes her toy, Lisa appears stunned and does not respond. If another child blocks her way out of an enclosed space or end of a tunnel, she will become afraid, panicky and eventually burst into tears.
  • Around 13-14 months, Lisa ran into the bathroom and saw the bathmat moved off the floor. She ran out of the room crying.
  • By 18 months, Lisa “freezes” and then bursts into tears if I talk to another mom at play gym or the park.
  • When Lisa is alone at the park, she makes sounds, sings, says words, and smiles; if another child approaches, she stops moving and making sounds. Her facial expression is blank. She stares at the child and is unable to continue with her activities.
  • Lisa stands off the sidewalk if she sees another person or dog walking, up to a block away (in either direction – behind or ahead of us). She waits for them to pass us (or turn a corner) before continuing.
  • By 21 months, Lisa smiles when she sees someone she likes arrive at a park (Grandpa, Gammie, Daddy), but when the person approaches, she shies away and hides behind my legs or indicates she wants to be held.
  • Lisa cried and hid when she observed Auntie letting out her hair from a ponytail.
  • At 2 years old, Lisa refused to get into the swimming pool when the music for aquacise was playing (although she was already in her bathing suit and showered). She said “no, stop” when the announcements played over the PA system at Science World and wanted to leave the Aquarium.
  • Lisa asks to sing songs outside music class and seems to express interest in going to class, but she will not participate in the class and “melts” into me if the teacher tries to touch her or speak to her directly.
  • Lisa is unable to go down the slide when another child is near the bottom or the side or is looking in her direction.
  • When staying at other places (grandparents’ house), Lisa reduces her food and liquid intake and appears distracted and unable to be calm.
  • Most recently, at almost 3 years old, Lisa reacted negatively upon seeing Daddy after he had trimmed his beard (no eye contact, avoidance). The next time Daddy trimmed his beard, we asked her to watch. After she watched and received a brave sticker, she was almost in tears and wanted to snuggle with Mommy.

If you met my 3-year-old daughter today, you would probably label her as shy and quiet. You might think she is timid and sedentary, and she may even seem a little dull! She probably wouldn’t speak to you and she might try to pull me away from you and eventually she might start crying from a seemingly miniscule event like falling down or eye contact! But she is a completely different child in her comfort zones at home, with select family members or outside alone. She sings, dances, runs, jumps, talks, builds, tells stories and moves constantly. This dual personality is typical of children with behaviorally inhibited temperaments [more info] and often only their parents and a few chosen people are privy to all the amazing parts of their personality. When my daughter was just under 2-years-old, I tried to record her different behaviours but unfortunately, she is also influenced by the camera such that she becomes more inhibited. I was not coordinated enough nor had the forethought to set up the camera unobtrusively. As a result, the differences that I captured are minimized on camera: the inhibited behaviour is more mild than typical because I couldn’t step back and film during extreme inhibition behaviours and she altered her behaviours, due to the camera, for the comfortable/uninhibited situations! Nevertheless, these videos provide a small glimpse into the range of behaviours exhibited by my behaviourally inhibited child.

My daughter exhibits inhibited behaviour. She is trying to tummy swing but focuses almost exclusively on another child and her mother playing on neighbouring equipment. The other child moves to the neighbouring swing and Lisa tracks the movement. Interestingly, at the time, I celebrated this behaviour because she was still able to push her feet against the ground. Typically, she would leave the swing and “melt” into me or hang completely limp on the swing. We were making progress!
My daughter is uninhibited while playing with the swings. She makes noises and is active. Daddy arrives and she starts tummy swinging and “cawing” like a crow, then says “sit” to indicate she wants help to sit on the swing. This video was recorded just 10 minutes after the “inhibited” video! Notice that she immediately changes tasks when she notices Daddy arrive. She does this even now. When someone arrives, she does not go to them nor hug them, and she barely acknowledges them. Instead, she will switch to a very active task. It is as if she gets a surge of adrenaline and needs to release it (my hypothesis is that this is the start of a “flight” response, but she is able to control it before completely succumbing to her amygdala).

As I tracked my daughter’s behaviours, I came across the description of a childhood anxiety disorder called selective mutism [more info]. When I read about the behaviours associated with selective mutism, it described my daughter perfectly. She was too young for us to determine if she was “mute” around other people, but everything else aligned well. I found a child psychologist in the city that specialized in childhood anxiety, selective mutism, and worked with very young children. While on the wait list, the psychologist recommended I start reading about the behaviourally inhibited temperament, since a 2-year-old would never be diagnosed with an anxiety disorder like selective mutism.

From what I have read, the behaviours of a child with either an anxiety disorder like selective mutism or a behaviourally inhibited temperament can be identical. Researchers have found that a behaviourally inhibited temperament in infancy is predictive of future social anxiety disorders, but not all people with an inhibited temperament will end up with an anxiety diagnosis (Kagan et al., 1992 and Degnan and Fox, 2007). Most children with anxiety disorders are diagnosed during school years, while temperaments can be detected by 3 months of age in infants. As I was writing this blog, I came across this article that proposes exactly what I have wondered: is an inhibited temperament different than an anxiety disorder or is it just an anxiety disorder that is observable in infants? The article does not answer the question as the research is not there yet. Ultimately, does it matter if your very young child (less than 3 years old) has an inhibited temperament or an anxiety disorder? If you’re looking at ways to help your child with behaviours and fears, then probably not; if you’re looking at how to understand your child and how to describe your child to other people, then it might make a big difference.

Mental health has a stigma associated with it. When someone hears that a young child has an anxiety disorder, they may have unhelpful thoughts:

  • the parent caused that (judgement)
  • the child is damaged (hopelessness)
  • the child should be fixed (judgement and power)
  • we need to make that child behave like this other “normal” child (control)

But if a person hears that a child has an inhibited temperament that is a stable part of personality, they will likely have different thoughts:

  • What is an inhibited temperament? (curiosity and learning)
  • I wonder what temperament I have and what I was like as a baby (curiosity and learning and possible recognition of genetic influence)
  • I guess that’s just who the child is (acceptance)
  • So that’s why that child is different than this one (understanding)
  • It looks like that child needs extra help with that task (empathy)

Many parents do not consider temperament when they have babies (and why should they? Not many people talk about it!), nor do they know how temperament is defined. Medical professionals do not educate new parents on this topic. Instead, they say the baby has “colic”, the toddler is “shy” or “slow to warm” (aka cold). Other parents can provide unhelpful advice such as expose the child and “socialize” them to fix their behaviours (aka cure them), leave the child to cry because this is the “real world” and the kid needs to adapt. But these words and ideas do not define temperament, they do not encourage respect of the child, nor do they validate that temperament is normal and stable. Children with different temperaments behave differently and that is okay.

One of my concerns as I read about behavioural inhibition, anxiety and treatments and prepared for my first appointment with the psychologist was that she would try to make me convert or change my daughter into the opposite of who she is. However, I was relieved when the psychologist confirmed that:

  1. Inhibited temperaments are stable through life.
  2. There is no cure for anxiety since the brain (amygdala) is designed to experience anxiety with fight/flight/freeze responses to threats.
  3. Bravery is not about eliminating fear but about accomplishing things that have meaning to us to lead a healthy and happy life, despite fear.

I often consider these points as I reflect on my daughter’s latest fears or most severe ongoing fears (talking and interacting socially). She is who she is. My job is to facilitate her interests and support her in finding contentment in her life. Hopefully, I will achieve this by providing a secure, loving foundation with tools she can wield to meet and overcome challenges. I want her to know that she can feel fear and still be brave and move forward towards her goals. She does not need to reach my potential or achieve my goals or become the person I am. Parents often talk about wanting their child to reach their full potential, but that is almost always code for wanting the child to reach the parent’s idea of potential. Ross Greene has a wonderful discussion in his book Raising Human Beings about accepting the cards you are dealt in life and moving forward together: parent and child. Will my daughter ever be the charismatic life of the party type? Probably not. Will she find a creative way to make her mark on the world? I think that is a very real possibility.

In my next post, I will describe seven useful strategies that we used to help our anxious daughter when she was less than 2 years old.

behaviorally inhibited temperament

The developmental psychologist Jerome Kagan studied temperament in infants and defined two temperaments: inhibited and uninhibited. Kagan described these temperament profiles as shy, timid, and fearful for the inhibited child and bold, sociable, and outgoing for the uninhibited child. Inhibited infants reacted more strongly to novel objects compared to uninhibited infants. Kagan and others also found that inhibited temperaments in infancy are associated with anxiety disorders in adolescence and adulthood. Researchers have suggested that parenting styles and cognitive behavioral strategies can positively affect an inhibited child’s response to novel stimuli, especially social situations, and reduce their fear response to prevent the onset of future anxiety disorders.

selective mutism

Selective Mutism is a childhood anxiety disorder characterized by a child’s fear of speaking in specific social situations (typically school). Children with selective mutism often have a genetic predisposition to anxiety and exhibit extremely inhibited temperaments as infants and toddlers. Like any anxiety disorder, the person’s brain has an over-active amygdala that is triggered into fight/flight/freeze by typically non-threatening events (like social situations). Many children with selective mutism also have sensory processing difficulties such that their brain may be over-reacting to smell, sight, touch, sound and/or taste stimuli causing inflexibility, frustration, and feelings of anxiety. A few typical behaviours include inability to speak in select social settings, blank facial expressions, lack of smiling, awkward body language, physical symptoms and negative behaviours prior to social activities.

brave story exposure ladder

Brave stories and exposure ladders for anxiety: a fear of the bike trailer

After great success conquering my daughter’s elevator fear, I was eager to try this method again. Conveniently, when you are around two 2-year-olds, there is always a fear that can be addressed. This is the story of how I put my 2-year-old niece in a bike trailer and thought everything was going great until an extremely fearful tantrum showed me it was not going great at all and I needed to slow waaaaaay down.

The weather was getting better and better and I wanted to start biking my daughter to the beach and forest. My husband and I decided to take my niece with us on our forest adventure. My husband rode his bike and I rode our e-bike pulling a double bike trailer to my sister’s house. I picked up my niece and started talking enthusiastically about going to “Turtle Pond” (a forested park with a pond that is a 5-minute bike ride from our house). My daughter has always loved the bike trailer and bike seat and she was sitting patiently in the trailer when I popped my niece in and away we rode. We had a great time playing in the forest. After dealing with my daughter’s meltdown right before we needed to leave Turtle Pond, I was trying to get the kids buckled in as quickly as possible so as not to be late for nap time. My niece was having none of it. She physically resisted (which is hard because she is tiny and slight with minimal muscle strength). I could have physically forced her into the trailer, but that is a parenting method I try to use very rarely. I stopped, pulled back, and talked to her about going to see her mommy. She said she wanted to drive back. I explained there was no car; this was the only way home. She continued to resist. Eventually, I think she misunderstood what I said and was somehow convinced to get into the trailer, but as soon as I secured the buckles she started screaming. The look of desperation and fear on her face was unmistakable. She screamed to be let out. And of course, just our luck, it was also raining so I zipped up the rain cover on the trailer making it even more of a constrained box. Thankfully, my daughter did not break down through all of this and sat their quietly (her meltdown came later!). Anyway, I looked at my husband with pleading eyes, thoughts whirling around: I do not want to bike this scared child; she is terrified; it is almost nap time, she’s probably tired and I have no other way of getting her home in a timely fashion. My husband convinced me to start biking and immediately she calmed down. Ok, I thought, maybe she did not know what the bike trailer was all about. This is fine. My husband played “peek-a-boo” with her during the ride home and got some smiles. I dropped her off and explained what happened to my sister in case my niece needed to “release her emotional backpack” in the form of a good cry again.

You can guess what happened the next time my husband and I tried to take my niece on an adventure. No dice. I had already told my husband there is no way I was going to strap a screaming Niece into the bike trailer. When there is so much fear going on, that fear needs to be addressed on her timeline, not mine. I do not agree with “sink or swim” methods as I think this can lead to phobias and I think it is disrespectful of the child as a human being [more info]. Instead, I took a step back and realized I needed to make a Brave Bike Trailer Story and exposure ladder. I also needed to figure out what exactly was fearful about the bike trailer from a limited-vocabulary, minimalist speaking 2 year old. Luckily, these things became evident one day during a walk. My niece said to my sister “tight” and “bump”. In a bit of context, we discovered that my niece was afraid of bumps in the bike trailer and the tightness/constraint of the straps. I included these two specific issues in the brave story (at the time, I knew the straps were an issue but I didn’t realize the word “tight” was related which is why it is not included in the story).

We read the story and started the exposure ladder:

  1. Read personalized story (reward: none)
  2. Bring bike trailer to front door for investigative play (reward: verbal encouragement)
  3. Bring bike trailer on walk to park for investigative play (reward: verbal encouragement)
  4. Offer ride in bike trailer used as a stroller (no buckles) (reward: book in trailer)
  5. Go over bumps in stroller-mode (no buckles) (reward: verbal encouragement)
  6. Ride in bike trailer for adventure with Mommy (reward: book in trailer)
  7. Goal: Ride in bike trailer for adventure with Auntie A (reward: book in trailer)

We stalled on step 2! Unlike my daughter, my niece had absolutely no interest in investigating the bike trailer and playing with the zippers and buckles. My daughter still spends many minutes sitting in the trailer buckling in her stuffed animal and zipping the zippers and asks to play in the trailer every time we use it. My niece could not have cared less about the trailer. I tried step 3 and there was minimal interest from my niece. She did not care about this trailer coming with us to the local park; she cared more about looking for bugs than zipping zippers. The next idea I had was to encourage her to sit in the bike trailer for a snack and I rewarded her with a chocolate chip. This worked, but I did not want to make this a habit since I do not allow my daughter to eat in the bike trailer. From this non-step, I discovered that my niece would get in the trailer under the right circumstances and she feels proud of herself for accomplishing brave tasks. Her smile was huge, and she clapped when I stated how brave she was for sitting in the bike trailer even when she felt scared.

My next idea was to use books as an enticement into the trailer. Unlike my daughter, my niece LOVES books. All she wants to do is have someone read books to her and she is also thrilled to flip through books alone. So, I collected a few small board books and put them into the trailer on our next walk. My niece walked along without so much as a glance towards the trailer. My daughter saw the new books and jumped into the trailer. This was finally the scenario that convinced my niece to get into the trailer. I decided not to secure the straps and just slowly pushed the trailer with the kids looking at the books. At the end of the walk, I specifically pushed it over some small “off-road” grassy bumps. I ended up combining steps 4 and 5 and we had success. I found new books for step 6, and with a beach destination my niece was excited. We set up the bike trailer, showed her the books, explained where we were going, and she jumped right in! We finished off the exposure ladder by leaving Mommy at home and now my daughter and niece happily ride in the bike trailer together reading books and singing songs.

I am relieved I did not force a screaming Niece into the bike trailer. Taking a step back and seeing the situation through her eyes and addressing her fears allowed us to move forward in a positive way that ended up right where I wanted her (able to ride in the bike trailer) and, more importantly, gave her a sense of bravery and accomplishment that we can now reference for future fears. The whole process took about 2 weeks with no tears and was not intensive (i.e. I did not read the story or implement the exposure ladder steps daily). This is an example of why you do not have to write the perfect story or make the perfect exposure ladder to get positive results. Give it your best first shot and then adapt as you learn new information from your child. However, developing a plan with thoughtful steps is important to prevent you from jumping too far ahead and going faster than the child’s pace.

In my next post, I will describe the behaviorally inhibited temperament, anxiety and the numerous behaviours I noticed in my daughter that were “different”.

Sink or Swim

I do not agree with using sink-or-swim methods on children for fears. I think the messages to children from sink or swim methods are negative and include:

  • The adult’s needs are most important.
  • The adult doesn’t care about my needs.
  • The adult does not know my concerns.
  • The adult is not going to take time to find out about my concerns.
  • The adult is bigger than me and can physically control me.
  • There is nothing I can do to stop the adult.

So even with a successful sink or swim method (i.e. the child eventually gets into the bike trailer without screaming/crying), the messages that the adult is sending are negative, aggressive, and controlling. Whereas, in a thoughtful, planned gradual exposure method based on the child’s fears and concerns, the messages are much more positive

  • The adult hears me.
  • The adult wants to help me.
  • I am scared and it’s okay to be scared.
  • I am brave.
  • I can do things all by myself.

We are all such capable adults that it can be hard to slow our life down and move at a child’s pace. But whenever we can take time, the results are so rewarding and go far beyond just conquering one fear. The child will develop greater confidence as their bravery increases as they face more fears when they feel in control of the progress.

The researcher in me is also curious if a person implementing a sink or swim method would find “success” any sooner than using a gradual exposure “planned” method. When you look at the grand scheme of life, two weeks is quite fast to go from fear of a bike trailer to happily riding for adventures!

brave story exposure ladder

Brave stories and exposure ladders for anxiety: a fear of elevators

I discussed explanatory stories in my previous post. Now, I will present the more common type of story used for anxiety: brave stories. A brave story is about a situation, person, object, or activity about which a specific child is frightened. I will use the word “situation” in the rest of the post in place of person, object, and activity for simplicity. A brave story is used in combination with an achievable goal that allows the child to better cope with the anxiety or decrease the severity of anxiety associated with the situation. This differs from the explanatory story, which does not have a child-led goal. The explanatory story is about a situation that exists over which a child has little or no control and may be inherently scary (sibling behaviour, COVID-19) but could also be mundane (wedding). The brave story involves the child taking control, taking action and feeling brave and confident, despite feelings of anxiety. The situation is not inherently scary.

Brave stories supplement direct action. The direct action is defined as rungs on an exposure ladder. Exposure ladders are an exercise in cognitive behavioural therapy. Each rung is defined explicitly, and the child is encouraged and supported by caregivers to reach that rung. Rewards may be used after reaching particularly challenging rungs, just as you might reward yourself with drink, food, clothing, or vacations for reaching a goal. Rewarding is not bribing. Bribes are used to convince a child to do something that you want them to do (on your timeline) and may have nothing to do with feelings of anxiety (i.e. a child is tired and does not want to get into their car seat. Offering a treat for getting in the car seat is a bribe). Rewards are for a child doing something (on their timeline) that elicits a sense of pride, despite feelings of fear (i.e. a child is afraid of the car seat and after explicit steps of exposure to the car seat is rewarded with a treat for getting in the car seat, despite feelings of anxiety). The distinction between bribes and rewards can feel fuzzy but it becomes clear when you work through an exposure ladder with your child. I can see the fear written on my child’s face when she does something scary and afterwards, she is beaming and proud of herself and asks for a special treat and is motivated to try again. Alternatively, I can see that there is no fear but just tiredness, hunger, or discomfort about getting in the car seat quickly on my timeline so giving a treat is a bribe.

One of my first brave stories was inspired by my daughter’s increasing hyper-vigilance about the elevator doors closing. Months ago, my daughter, niece, sister and I got trapped in my condo building’s elevator. We were trapped for about 30 minutes while we waited for the fire department to rescue us. My sister and I maintained calm speaking voices, video chatted with grandparents and sang songs. But my daughter was clearly terrified. She reverted into her non-verbal, limp rag-doll state. After the event, we got her running around outside and she seemed okay. She also played “elevator rescue” with my husband for weeks afterwards in our home. A few weeks ago, as I was trying to maneuver a bike into the elevator, the bike fell, and the doors started closing with my daughter inside the elevator and me outside. I was able to press the call button and the doors opened before they completely closed, but I could see my daughter’s terrified face. The following weeks, I noticed that my daughter became hyper-vigilant about making sure everyone got on/off the elevator without the doors starting to close. I thought her anxious behaviour would lesson over time, but it seemed to get worse, so I decided to write a Brave Elevator Story. I also created an Elevator Exposure Ladder that my daughter and I worked on over the following weeks. Before each step, I talked about what we would do.

  1. Read story
  2. Show Lisa how I can get the doors to open by pressing buttons (outside elevator)
  3. Show Lisa how I can get the doors to open by pressing buttons (inside elevator)
  4. Put Rabbit (stuffed animal) on the elevator alone and watch the doors close. Talk about how Rabbit is safe. Mommy pushes call button and we give Rabbit a hug. Repeat.
  5. Mommy goes on elevator alone while Lisa waits outside the elevator. Lisa watches the doors close and Mommy opens the doors again by pushing the buttons (Lisa is praised for bravery and receives a sticker). Repeat.
  6. Mommy goes on elevator alone while Lisa waits outside the elevator and Mommy rides the elevator one floor down. When the doors open, Mommy calls out to Lisa that Mommy is still on the elevator. Mommy rides back up to the floor where Lisa is waiting. (Lisa is praised for bravery and receives a sticker). Repeat.
  7. Lisa goes on the elevator alone and watches the doors close and Mommy pushes the buttons outside to open the doors. (Lisa is praised for bravery and receives a sticker).
  8. Final Goal: Lisa goes on the elevator alone and watches the doors close and Daddy pushes the elevator call button on another floor. Lisa is alone on the elevator when it moves to the next floor. The doors open and Lisa sees Daddy at the new floor. (Lisa is praised for bravery and receives a sticker). Repeat.

I did not think my daughter would reach the goal. This is not the best way to start an exposure ladder. It would be much better to have confidence that your child will succeed. I created the exposure ladder based on my own idea of logical, sequential steps but without a lot of thought of my daughter’s age (2.5 years old) and developmental stage. In hindsight, I should have given this greater consideration and with a different child, I might have stopped the ladder at a lower point. Ultimately, I thought there was so much fear around the elevator that my daughter would never ride the elevator alone (at this age). But isn’t the point to alleviate some of those fears? Anyway, without more thought, I blazed ahead with the plan.

The story intrigued my daughter and we talked about the elevator a few times after reading the story, reinforcing that the elevator was safe and that Mommy can always open the doors (ok, except the freak time when it stalls and you have to wait for the fire department but that’s pretty rare and I decided I was not going to address that in this round of story-exposure-ladder action). I waited for a week or so of reading the story before starting the ladder. Each step was refused by my daughter. I would smile and say, ok, maybe next time we’ll try that. EVERY time, my daughter would wait a couple of seconds and then say, “ok [let’s try it]” and we would try the step. My daughter is one of those kids that loves to please (me). She wants to do what I suggest and has a rule-follower type personality, so this often works to my advantage. I stay enthusiastic, upbeat, and encouraging and eventually my daughter usually complies. Not everyone is so easy (as we will see in another example with my niece in my next post). But her reactions in steps 2-5 gave me more and more confidence that we could achieve the next step. That all stopped at step 7 though. I still hesitated to push her to step 8. Was this step really necessary? Does a 2.5-year-old need to ride the elevator alone? I decided I wasn’t going to push it, but one day I accidentally pressed the wrong floor button. As we were going to the wrong floor, I said, “I could jump out and you could ride the elevator all by yourself to our floor and I’ll meet you up there”. She said, “ok”, without much thought and everything happened too fast to change our minds. Away she went in the elevator while I ran like never before up the stairs to get there before the doors had fully opened. She came out grinning and gave me a hug. She was so proud of herself. She now asks to ride the elevator alone, so I purposely push the wrong floor button and jump out and take the stairs to meet her. Her bravery surprised me! Interestingly, through all the steps, the first few times of each step were clearly causing feelings of anxiety. Her fear was written all over her face as the doors would close, but she would always come out grinning and excited that she had done it “all by myself!”

I learned some valuable lessons from this experience.

  • My daughter is more capable than I thought!
  • When creating exposure ladders, it is important to consider age and developmental stage and to remember that every 2.5-year-old does NOT need to ride the elevator alone. My daughter experienced so many feelings of bravery from steps 4-7 and she stopped being hypervigilant about the elevator doors by step 7, so that is where I should have stopped the ladder. Step 8 was just a bonus.
  • It is okay to take breaks during the exposure ladder and regroup (I took a long break between steps 7 and 8).

Older children can participate in creating the Final Goal and the Rungs (steps) of the ladder, but for very young children, the caregiver will create the goal and ladder. If you have never worked with an exposure ladder for anxiety treatment, try it first on yourself. Pick something that truly gives you feelings of anxiety and fear. If you don’t have an anxious temperament or many fears, this may not be feasible for you. I have done an exposure ladder on my own phobia which helps me understand what my daughter will face at each step. This gives me a sense of empathy that is truly authentic! It is helpful to have an adult describe the feelings and thoughts for their own personal ladder rungs so you know what your child might be going through even though they may not be able to articulate those thoughts and feelings.

Before I started writing brave stories, I created a Dentist Exposure Ladder with the help of the child psychologist. One of the rungs on the ladder was to read a dentist story. I used Daniel Goes to the Dentist (the book based on the story from Daniel Tiger’s Neighborhood TV show) adapted by Alexandra Schwartz because it was one of the only stories that showed a simple cleaning visit (no x-rays, surgeries, teeth pulling, etc.). I saw how much this story helped my daughter think about the dentist and realized that a personal story (with specific language and images) would have been even better. The combination of Exposure Ladder and personalized Brave Story is more likely to succeed in reducing anxiety, converting an unknown situation into a known situation, and creating positive feelings of bravery in a child than either strategy in isolation.

In my next post, I will describe a Brave Story and Exposure Ladder for a bike trailer fear with a child less eager to please me!

explanatory story

COVID-19 story for young children

A few weeks into isolation recommendations amidst the coronavirus pandemic I noticed some changes in my 2.5-year-old’s behaviour: more tantrums, constantly asking to eat, and more stuttering. I know her behaviourally inhibited (anxious) temperament causes her to have strong reactions to changes in routines, so I was not surprised. However, I thought the routine changes would reduce her social anxiety since she was no longer having to confront situations like music class, forest school or play gyms. I wasn’t too concerned with the changes, but I was having a hard time understanding her through the stutter and my husband was definitely worried. I made a virtual appointment with a child psychologist that specializes in anxiety. I had seen her weekly for a couple of months the previous autumn to get a better handle on behaviourally inhibited temperament, childhood anxiety and treatments. I wanted her to weigh in on whether my daughter’s “new” pandemic behaviours were normal. She made three recommendations: 1) stuttering is out of her wheelhouse and I should get referred to a speech and language pathologist (SLP), 2) make a simple routine chart showing our daily routine and meal times, and 3) talk to my daughter about COVID-19.

I diligently checked off the recommendations. We are on a waitlist for an SLP. I made a simple chart showing our daily activities including meal times and within a few days of posting it, my daughter stopped asking for food constantly. I felt uneasy about recommendation 3. I know it’s important to talk about the pandemic with children to help alleviate anxiety and I had already seen plenty of stories and articles about how to talk to your kids about COVID-19, but I hadn’t seen any stories appropriate for a 2 year old. The stories I read had a detailed description of COVID-19 and viruses and often described school being closed. The stories also seemed to assume the child had already heard words like pandemic, virus, coronavirus, COVID-19, etc. My daughter had never heard the word virus, let alone coronavirus, and did not relate to school closures. We don’t use screens, other than for video chats with extended family, so she wasn’t being exposed to information from the news. My husband was working fulltime from home and I was a busy mom and aunt; he and I did not discuss the pandemic in front of her. I assumed she didn’t have any idea what was going on. I was seriously thinking about ignoring recommendation 3. How could I explain this pandemic in a helpful way to my 2-year-old and how was talking about a virus really going to help with her tantrums? But, as a rule-follower, I find it hard to go against expert advice, so I gave it more thought and decided to write my ideas because I don’t do well trying to speak off the cuff (thank you, INTJ personality and behaviourally inhibited temperament!).

After some brainstorming, I concluded that the best format to deliver COVID-19 information would be a short, personalized story. Prior to this point, I had written a couple of Social Stories for a friend with an autistic child. I had written them in a rush and took some basic pointers from my friend about how they should be written. I decided to write a “social story” for my daughter about COVID-19. But I did not adhere to any specific principles of official Social Stories, per se. I focused on how to address anxiety for a very young child. For content ideas, I read articles from and Psychology Today. My goals for the story were as follows:

  1. The story is understandable
    1. Use age-appropriate (simple) language
    1. Use words that I know my child understands
  2. The story is relatable
    1. Use lots of personal pictures
    1. Describe the current unknown situation in relation to known situations
    1. Describe how we help
  3. The story is factual (not fearful)
    1. Highlight both positive and negative changes to my daughter’s routine
    1. Explicitly state positive and negative feelings

I wrote the story and was amazed at how much my daughter enjoyed it. Weeks after reading it she still talks about the “new cold” in relation to activities in our lives. If I say, “no” about something she will ask, “because of the new cold?” I was able to refer to the story when she resisted washing her hands after coming inside and avoided a few (not all!) meltdowns. The story provided us with a platform to talk about the changes we continue to notice when we go out for walks. It also provides my husband and I (and my parents and sister) the same language to consistently reinforce the story concepts.

Now that you have read the story, you might feel that it is not right for your family. That’s good! A story like this should not be right for anyone else’s family. It is critical to personalize these stories when you are using them for very young children. As children age, they gain life experience such that there is a greater chance that a generalized story is applicable to that child. However, for young children with very short memories and limited experience, it is important to adjust the story to fit the child such that it is understandable, relatable, and factual, from that specific child’s perspective.

I will review a few aspects of the story and how they relate to the three goals. Then, I will analyze some statements from a generalized COVID-19 Social Story to see why those statements are not useful in a story for my child and probably most 2-year-olds.

  • I call the coronavirus (COVID-19) the “New Cold” and people who have the new cold are referred to as “Sickly Sues”. This might seem like strange language to you, but I considered exactly what words I had used since my daughter’s birth to describe when we got sick (with anything – common cold, flu, food poisoning, headache, roseola, etc.). I most commonly used the words “cold” and “Sickly Sue” (That is a family thing – thanks, Mom!). Your family might use “Sniffles” or illness. The point is that I knew my daughter had feelings associated with those words. She used those words to describe herself when she was sick. Using this vocabulary supports goals one and two: understandable (language) and relatable (feeling of sickness).
  • I explain that some people wear masks like dentists and Mommy makes masks for our family and I have a photo of my daughter wearing her mask. Luckily, we had talked about masks prior to COVID-19 because of the dentist. We had already started our anxiety exposure ladder leading up to visiting the dentist and covered our faces with scarves while playing dentist. If you have not talked about the dentist in your family, try to think of another positive mask association that your child has. Maybe you have seen people cover their faces in the winter when skiing or playing in the snow. Maybe your child likes construction and they have seen a welder’s mask. Doctors, nurses, welders, carpenters, etc. The discussion of masks supports goals two and three: relatable (dentists wear masks) and factual (stating that masks are being worn without adding judgement or fear like relating the masks to robbers or “bad guys”).
  • I talk about “helpers” (i.e. doctors help, [Name] helps) because toddlers and young children love to be helpers! My daughter turns on the washing machine and dishwasher and we have talked about how to help someone who is hurt (ask if they are okay, get an adult). Being a helper is something she understands from other activities in life. So, instead of being burdened by having to wash hands, use sanitizer and give others space, it is empowering that this little person is helping with the “new cold”. Describing “helpers” supports goal two: relatable (helpers existed before the pandemic, exist during the pandemic and will exist after the pandemic).

Here are a few statements from a typical COVID-19 social story and why they don’t work for my daughter. Although I am reprinting statements from this story, most other stories had these same kinds of statements:

  1. The Coronavirus is a virus that can make people feel unwell. The coronavirus can also be called COVID-19. My daughter doesn’t know the word virus, Coronavirus or COVID-19. It’s too much detail and would have been superfluous to include a statement with synonyms of coronavirus.
  2. People who have the coronavirus may have fever, sore throat/dry cough, shortness of breath. This is too much detail for a young child; they likely won’t stay engaged for a long list of symptoms. I chose a single symptom (cough) in my story; I also selected a symptom that I knew my daughter understood (cough, not dry cough). I like the symptom “cough” because it is something we can easily play/pretend and she can see it (body tensing, hand/elbow covering face) and hear it.
  3. I know that I will be safe… I like the idea of stating that a child is safe, although I didn’t include that message in my story since there was no focus on the danger/threat/safety aspect of the pandemic; I didn’t discuss family members getting sick or dying because it was low risk for us. If I lived in a different place, that might be more relevant. Instead, I included a phrase from Daniel Tiger’s Neighborhood that we learned about in our Daniel Tiger Goes to the Dentist book, “When we do something new, let’s talk about what we’ll do.” I sing this phrase constantly for anything we do that is “new” and scary. Although the phrase is not correct for this situation, the feelings behind it are empowering to my daughter. This is one more personalized aspect of the story to keep my daughter engaged and feeling confident. I also included the phrase, “mommy, daddy and [Name] will always be a family.” This phrase is more powerful than the “safety” concept because even if mommy or daddy die, we are still a family. Relationships and family transcend death.
  4. …and I don’t have to feel afraid. I would not include this kind of statement in any story. No one has to feel afraid, but they do! I prefer to phrase feelings as simple statements like “I feel sad. I feel scared. I feel happy.” Negative commands are confusing and try to control how a child feels. Statements such as “I don’t have to feel happy. I don’t have to feel sad. I shouldn’t feel mad” may be confusing for a young child if they are experiencing a feeling that the story has told them not to feel. If you incorrectly guess a child’s feeling by writing, “I feel happy” when they actually feel sad, the child can say, “no” and then you can correct it. But if you write, “I don’t have to feel sad”, the child cannot easily respond “yes/no” because a statement written in the negative is more confusing for a young child to understand and then relate it back to what they are actually feeling.

It is June now and the city is starting to open up again, but I am resisting diving back into old patterns, as I expect a second wave of the virus and I’d rather try to hold steady instead of implementing more routine changes, suddenly. The story and routine chart helped to reduce some anxiety. In addition, enough time has passed such that our new isolation routine has now become our routine, and my daughter is surrounded by people with whom she feels comfortable and she isn’t having to confront anxiety-producing social situations. I believe my daughter’s stutter is caused by anxiety and her temperament and not by a developmental issue. Therefore, my hypothesis is that if we address the anxiety, improvement in stutter will follow. COVID-19 caused the elimination of most of my daughter’s anxiety sources. I’m not saying elimination (avoidance) is the best way to deal with anxiety (more info) and without COVID-19 I wouldn’t have self-selected this isolation just to see what happens, but now that it has happened, it’s amazing to see my daughter flourish! The stutter (more info) has improved to better than pre-COVID levels and tantrums are down. I hope that in this state of low anxiety, my daughter will be able to practice and solidify stutter-free speaking patterns. I am curious if, by eliminating most social situations and allowing her language to develop in a low anxiety COVID-19 isolation bubble, she will maintain that language and speech pattern when we eventually face new social situations. We may still need to employ exposure ladders for those social situations, but will her speech patterns be affected? Only time will tell! (And we have the SLP waitlist in our back pocket.)


Avoidance is precisely the wrong way to deal with anxiety because it does not help a person learn skills to cope with anxiety. It just pushes it out of the way until later. A person who avoids the fearful event/object will still experience anxiety when confronted with it in the future. Find out more about anxiety at However, for extremely young children, there is also a developmental component to consider. Separation anxiety is normal in babies and toddlers and there is a large “normal” range of behaviour. As a scientist, I like to follow evidence-based parenting practices, which support non-avoidance exposure ladders for treating anxiety in children. However, most research is based on older children (school-age+) and adults with diagnosed anxiety disorders and it is often just assumed to work for young children (when it is still thought of as a temperament and not a disorder).


My daughter has stuttered since she started talking at 2 years old. Usually I understood what she was saying through context and I even thought her stuttering was improving before the isolation rules came into effect. Prior to the pandemic, she exhibited whole word stuttering (5-20 times repetition of a word); for example, during snack time after music class she said, “got got got got got got got got got got got got… JAM!” which was an exclamation about the sandwich containing real jam instead of apple butter. During isolation, whole word stuttering continued as well as being “stuck” (no sound comes out and she was stuck on a word with her mouth open and muscles visibly straining to get the sound out) and sound holding, like “I want to go hoooooooooooooome”.

In the next post I will further discuss explanatory stories for young children with an example of coping with an autistic sibling.