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QUESTIONS & ANSWERS

Is it a Big Problem or a Little Problem Quiz

This is a quiz to help inform parents and caregivers about how to handle common behavior “glitches” with their children and to identify when different strategies and tactics can be employed at home or school and/or when to seek a professional intervention. If any behavior is interfering with your child’s success, happiness and/or progress at home or school it is a big problem.

1. Your three-year-old has tantrums that can be very violent—he throws himself on the floor and even bangs his head sometimes. He always seems to do it at home – never at preschool.  Is this a Big Problem or a Little Problem?

□ Big Problem     □ Little Problem

2. Your 3-and-a-half-year-old daughter talks all the time but the only one who can understand what she’s saying is you. Is this a Big Problem or a Little Problem?

□ Big Problem     □ Little Problem

3. Your little boy is a “bull in a china shop.” He crashes into walls, walks over toys, hugs his friends too tightly and pushes them to say hello. Is this a Big Problem or a Little Problem?

□ Big Problem     □ Little Problem

4. Your little girl is always falling and seems weaker and less coordinated than other children her age. Is this a Big problem or a Little problem?

□ Big Problem     □ Little Problem

5. Your little boy has normally developing language and speaks fine at home but does not talk at school. Is this a big problem or a little problem?

□ Big Problem     □ Little Problem

6. Your 4-year-old never responds to requests or directions the first time. He always giggles and runs away like it’s a game, until you get really mad. He’s well-behaved with the nanny though.  Is this a Big Problem or a Little Problem?

□ Big Problem     □ Little Problem

7. Your little girl has a fit when she finds she can’t wear her favorite outfit to school, screams as if she’s being hit when you try to put on new socks with a ridge in the toe and falls to the floor in a heap when she finds that another child at school is already playing with her favorite toy. Is this a Big problem or a Little Problem?

□ Big Problem     □ Little Problem

8. Your 5-year-old little girl is so tired she’s falling on her face, but she won’t give up, calm down and just go to bed. You have to go back to her dozens of times and even when she finally falls asleep in tears her sleep is fretful and she wakes several times during the night. Is this a Big Problem or a Little Problem?

□ Big Problem     □ Little Problem

9. Your generally sweet-tempered little boy usually comes along when you run errands but he’s all over the place and makes what should be a fifteen-minute quick grocery run into an hour-long ordeal of negotiating over what he wants to buy, bumping into things and going to the bathroom. Is this a Big Problem or a Little Problem?

□ Big Problem     □ Little Problem

10. Your 4-and-a-half-year-old son has no interest in learning how to write his name.  He gets mad whenever you try to get him to sit and write with you.  He just wants to play with his toys and his friends.  You’re worried that he won’t be ready for kindergarten in the fall. Is this a Big Problem or a Little Problem?

□ Big Problem     □ Little Problem

ANSWER KEY

1. Little problem. Tantrums at two and three are common.  These children do not wait well, they are not strong language users yet, they are still ego-centric and want everything their way.  This child shows he can “rein it in” during school and behave according to classroom expectations, another indication that this is a little problem. He shows less restraint at home, because that is where he is most comfortable. Children often, but not always, outgrow tantrums by age four or so when they learn how to use words to express themselves, negotiate, and wait.

2. Big Problem. Generally, by the end of the third year, most children’s speech is intelligible to others. If your child is having a difficult time being understood and feels she cannot talk to her peers because they won’t understand her, the problem is interfering with her happiness and success. A speech therapist should do a formal speech and language evaluation.

3. Little Problem. Your child may be experiencing problems with processing sensory information. Specifically, he’s craving deep pressure into his muscles and joints (or seeking proprioceptive input).  Offer activities that provide “heavy work” such as hanging from monkey bars, jumping on a trampoline or playing with clay and playdough. If the behavior does not diminish with more opportunities for these types of play, consider seeing an occupational therapist.

4. Little Problem, most likely. If a child falls often and seems less coordinated note if her motor skills are typical but on a slower time table, or if there is a significant difference in how she moves and uses her body.   If the latter is true, parents should discuss this with their pediatrician and possibly seek a referral for physical therapy.  If her motor differences seem to be related to sensory processing such as her inability to figure out how to move, clumsiness or fear of movement she may benefit from an occupational therapy evaluation. Parents contribute to solving this problem by giving the child many opportunities to practice her motor skills at home and on the playground.

5. Big problem. A child who doesn’t talk in school but talks easily at home is cause for concern..  Selective mutism refers to a child who speaks freely in some environments where he or she feels safe or secure, such as home, but is rendered virtually silent in other environments perceived to be socially challenging such as school.  A child who is selectively mute has difficulty communicating basic needs in this environment, such as the need for a bathroom break or a drink of water.  Teachers may have difficulty ascertaining academic levels of a child who doesn’t speak at school. A mental health professional, such as a psychologist can work with teachers and parents to support the child. A speech pathologist may also help the child socialize at school or an occupational therapist may work with the family to help the child handle the sensory rich classroom.

6. Little Problem. We know this is a little problem because it is person-specific.  No problems at preschool, no problems with the nanny.  The problem lies in the way parents are following through (or not) when they give him instructions.  The goal, is to teach them that you mean what you say THE FIRST TIME.  Don’t issue an instruction until you can follow through with it.  Be sure the child is listening.  Make it clear, through your actions as well as your words, that you expect him to follow your directions:  push a box closer to him when it is time to put away toys or put blocks into his hand to “help” him clean up. 

7. Big problem. This little girl is likely experiencing problems with sensory processing. Her differences are interfering greatly with her ability to function in a variety of environments. Children who have trouble adapting to small changes in their clothing, food, routines or play may feel disorganized and respond by trying to gain more control over their world. This child needs intervention by a pediatric occupational therapist to help normalize how she processes sensory information.

8. Little problem.  This little problem has a big impact on everyone! It sounds like
   this child has difficulty with regulation:  her “motor is running too fast” and she lacks the ability to self-soothe and slow down.  Careful attention to nighttime routine is critical as are a good diet and sufficient sleep.  The pediatrician is a key player for establishing that the child is in good health. But, an occupational therapist  can be consulted to help this family develop an action plan.  

9. Little Problem.  It may feel like a big problem, but it is situation-specific:  he’s a pretty agreeable little guy except when running errands.  Plan strategically: Be sure he understands the plan and maybe work in a visit to a kid-friendly shop.  If he can read, make him a list of all the errands, if not, draw a quick “picture” schedule.  Let him cross these off his list as you finish each and tell you what is next on the list. This way he’s occupied and can see that you’re making progress.  Give him other little jobs along the way so he gets your attention for being a good helper.

9. Little Problem. It is not uncommon for boys this age to lack interest in fine motor activities—they are usually more drawn to construction play and large motor activities. The important prerequisites that they need are the ability to sit for short periods of time and maintain attention, coordinate their eyes with their hands, have established hand dominance and be dexterous in other kinds of hand use, i.e. building with small blocks and using tools like scissors, markers, and crayons.  They should recognize their name and know the letters before they are able to actually hold the pencil adaptively and write their names. When a child is ready, handwriting should be fun. It will happen quickly if those prerequisites are developed.  If parents are concerned that he is not developing these prerequisite skills, they may want to consult with an occupational therapist.