Pacific Coast Society of Orthodontists Bulletin Summer 2020 - 76

Practice Management

Provider Tips and Tricks

Skip the Lecture: Be a Role Model to
Parents Whose Kids Struggle With
Home Compliance

Ms. Rachel Sklar
Hayward, CA

My middle son developed a habit of clicking his
retainer in and out, which caused it to loosen and
fall out almost weekly. Eventually, his orthodontist
and parents became so frustrated that the decision was made to cement it in place. Before this
decision was made, his orthodontist made several
attempts to remind him to stop playing with it and
even explained all the reasons why he should stop.
All of which worked to no avail.
Although I'm a mom of three and a parenting
expert, I still look to my kids' doctors for concrete advice on how to motivate my boys to take
responsibility for their own health. Coaching tips
on how to inspire good compliance at home are
appreciated as is assurance that their resistance
is not abnormal. To be effective, however, this
advice should strike a balance that prevents
power struggles or frustration and seeks to validate a child's point of view. Too often I find my
kids' many health care providers simply lecture
them on the need for better home compliance.
But to be completely honest, simply lecturing my
kids to "eat healthier," "do their physical therapy
exercises," or "brush their retainer" is almost
completely ineffective, because at some point
before the lecture is complete, they roll their
eyes and ignore it.
After three kids, two rounds of braces, four headgears, a Bionator, several retainers, years of rubber
bands, and innumerable lectures, I finally took a
step back, put on my "parent coaching hat" and
reflected on how our orthodontist and I could more
effectively inspire compliance, especially in children
who frankly are not interested in any of it.
Let's establish the basic fact that a child's brain
is not fully developed. They're often not great at
impulse control and may not be able to adapt their
current behavior to match their long-term goals.
They live for the moment and, depending on their
temperament, may be extremely committed to
their own point of view. Trying to convince these
kids of our most wise and valuable perspectives
will be ineffective at best. At worst, it will leave a
child feeling misunderstood and more resistant.

76	

In parenting workshops, I teach that human beings
are more intrinsically motivated when they feel a
deep sense of belonging and connection. Lecturing
my son about cooperation and home compliance
does not inspire intrinsic motivation, but continually
connecting with him throughout his daily routine
seems to do the trick and has built independence
over time. The best way I've found to motivate my
son is by validating his point of view before all else.
I try to articulate what the world must look and feel
like from his perspective and show him that I get it,
that the struggle is real, and that he's not alone. I
prioritize my connection with him over rubber bands,
retainers, flossing his braces, and convincing him that
I'm right (even if I am). When I do that, his defenses
go down and his cooperation goes way up. Fulfilling
his underlying desire for connection is also more
effective than rewards and consequences.
What's an orthodontist to do? To improve home
compliance, make sure you empathize and connect
with your patients and also let parents know that
taking this approach with their children can help
prevent power struggles and improve motivation.
An example conversation might be, "When it's time
to put on your headgear, what would you rather be
doing?" And, "Yeah, Harry Potter and Xbox are more
fun. I agree." And, "Instead of getting frustrated, can
your mom help you set up a system for getting your
headgear on every night?" And, "It's probably annoying when grown-ups nag you about this. Maybe you
can put on your headgear while doing something
you and your mom enjoy more."
I advise parents to come up with a few scripts that
invite connection, rather than leaving kids feeling
shamed or blamed for how they are. Perhaps
health care providers can keep a few scripts in
their back pockets that show understanding for
the child's point of view while role modeling an
approach that validates the challenges of home
compliance for everyone.
Rachel Sklar provides virtual parent coaching
services and workshops, and she consults with tech
companies aimed at improving the lives of parents
globally. To connect, visit her at rgsklar.com.
PCSO Bulletin    Summer 2020


http://rgsklar.com

Pacific Coast Society of Orthodontists Bulletin Summer 2020

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