Removing barriers to engagement

Some time ago I wrote about barriers to engagement with children who have Selective Mutism, now I have been thinking on a follow up post to give those working with children or who are parents how to approach each situation with a chance of success.

While reading on a facebook page called the Autism Discussion Page in a post I read

"Parenting a child with autism often means wearing multiple hats (mother, father, therapist, teacher, researcher, advocate, social mediator, biomedical doctor, etc.). You have to continually multi-task to keep up with the chaos. Parents of young children on the spectrum often have an overwhelming sense of urgency, to do as much as possible to help their child overcome their challenges and develop and grow to their maximum potential. This is very understandable and recognizable in many parents of young children. However, we have found that often we move too fast in our urgency to provide for our children. The world moves way too fast for these children, and we need to slow it down to maximize learning."

Now I have to mention this paragraph because it was this that caught my attention after my recent post at the end of it all, I choose who I am discussing my heart ache when it comes to parenting a child with special needs and the demands it places on the parent. This small quote speaks to me also of the pressure we feel as parents to intervene in our children's lives to help our children to "overcome their challenges and develop and grow to their maximum potential".

For some time now I have been trying to understand what is different about how people interact with children and why do some people have a large amount of success and others don't. From observing parents who interact with my son I have noticed parents in particular who have children with autism actually seem to be able to engage with my son on a different level and make a large amount of progress in social interaction with my son in a short amount of time.  This puzzled me as to what the difference was, until I read this discussion on "declarative and imperative language"

"When using words, use more "declarative language" instead of "imperative language." Imperative language is any statements that direct a specific response from a child (questions, directives, instructions, prompts, etc.). Declaratives are any statements that invite, but do not direct a specific response from the child (statements share information, ideas, thoughts, feelings, experiences and perspectives)."

Now I don't know if this is a major revelation for any of you, but this totally relates to children with Selective Mutism. The nature of their diagnosis is anxiety and often the very style of therapy and interactions most people use with children actually makes their situation worse and they retreat further into their shell. If you struggle with anxiety being put on the spot and asked questions such as how are you today, say thankyou, say please actually increases the anxiety rather than reduces it. It is so frustrating to watch well meaning people who want to engage with my son sabotage the situation by not understanding these concepts. Relating to Selective Mutism, there is also a theory around communication load which supports this concept. 

In the past I wrote a short blog article on the topic of "communication load" the way we communicate has a direct relation to the impact and success of encouraging a child with Selective Mutism to speak, Maggie Johnson describes the Communication Load in terms of low, medium and high and also provides a description of activities that fit into each category, I have written a post on this topic with slideshow like pictures to describe the concept, please check out communication load revisited here before you continue!

"Normal interaction between two people usually consist of about 20% imperative (questioning, directing) and 80% declaratives (sharing ideas and information). However, when we interact with children on the spectrum the ratio is turned around; usually 80% imperative and 20% declaratives. Children on the spectrum tend to freeze up and resist imperative language. They tend to have strong "performance anxiety" and pull back from imperative (directive language). Just like us, no one likes to be questioned, prompted, directed all the time."

No surprise when reading this we actually find the same with Selective Mutism, when people don't pay attention to how they communicate and invite and encourage speech, it is so easy to be caught in the trap of questioning and directing rather than declarative language, this can also be described as commenting, statements talking as though they might respond but continuing if they don't take the opportunity. I wonder how much of our interaction is based on how we feel rather than how the child feels. It is incredibly confronting when a child doesn't respond verbally when we want them to. This author goes onto discuss how we can change or rephrase the way we speak it is also similar to the concept of open ended or close ended questions. He then makes the claim that we can "usually get three times more interaction from the child when we use declarative language."

Once you have considered how you speak, the next stage is to actually consider how you respond when waiting. A popular concept with Selective Mutism intervention is to freeze the moment this applies to allowing your child to respond and letting them experience the space in conversation so that they have more of a chance to speak up. So once again reading this short post I find another concept that is also applicable to Selective Mutism treatment.

"Learn to pause and wait! Children with delayed processing need time to respond. They have to process what is coming in, appraise what is needed, and formulate how to respond back. In our haste we often jump in and continue to prompt, or respond for them. Waiting is the hardest thing to do. It is much slower than our nervous systems want to wait for. It tasks patience and practice, but is very important. Slow it down, and give them a chance!"

If you also add into the equation speech delays and disorders it is even more important to slow down communication and responses. Giving your child time in the therapist office or in your company to respond in any given situation will make a big difference. Let's not allow our hurried lives to also run into our relationships with our children, students and clients. The challenge is while you are interacting with your child, how do you do it? are you putting too much pressure on your child by attempting high load communication activities before they master the low load communication activities? Slow the process down and take the time your child needs and desires. I hope all the information I have provided in this post won't be too much but I feel these concepts adequately describe how to encourage communication with any child regardless of their diagnosis.

Communication Load Revisited

A long time ago I discussed the concept of "Communication Load" and their activities devised by Maggie Johnson in her book. Please note all of this information on these slide power points are from Maggie and in they are not my own! 

If you love this information like I did, there is so much more in her book the "Selective Mutism Resource Manual, this manual is for parents and therapists alike, it provides handouts of information you can give to others to education on Selective Mutism as well as treatment plans and general information and guidance. I refer to this book ALL the time and love her treatment model, by far it is the most practical and simple to implement for any person with the time needed. 

To read more on communication please check out my following post "removing barriers to engagement".

At the end of it all, I choose who I am!

Once again I'm sitting in a speech therapy appointment (for anyone who is a therapist, please don't take this sharing to heart) discussing ways of helping my son learn to speak better and the relationship of talking, questions and how as a parent we encourage our children to speak. To be honest I felt under pressure, as though every conversation I have to think of myself as a therapist constantly on the job and trying to think of ways to help my son learn new concepts and learn how to say things better. Mentally I am tired, the stress of being that type of Mum is hard work. 

What do I feel inadequate, not as a person but inadequate to make a difference, to do ENOUGH to help, is it going to make a difference, thinking I should have done more, done less, under pressure that it's not going to be enough and my kids will be the same developmentally. More than anything I feel like no-one actually gets it. The pressure is on the parent, not society, it's all on me, if I don't do it no-one will.

It's not often I say what I feel about the situation. Selective Mutism is a curable condition with early intervention you can actually OVERCOME this condition, however without intervention this is impossible. Where is the funding? certainly not here for my son. This is what we get: 10 speech sessions a year (apparently this is decreasing now as he gets older) through child development, 5 medicare sessions a year, 10 sessions via mental health care plan a year. We are not eligible for any help from Disability Service Commission because apparently they don't help anyone with mental health issues as their primary diagnosis, the Mental Health are supposed to help them (apparently). 

The reality what have I seen time and time again recommended in EVERY documentary, the therapy recommended is at least the following for the sliding in technique they use at a minimum 3 sessions a week of around 20 minutes for TWO months this is just the beginning. So naturally what we are currently getting is not enough, given that I am spending my time at home we live on the Carers Payment (thank God for small mercies) I really am struggling to find the money to bridge the gap. 

The issue with this whole story, the parent is where it is at. Because of the funding issues the rest of the therapy burden is put upon the parent. Often I see what I receive from say child development or such places it is more a consultative approach, they tell you what to do rather than actually do the therapy. Homework for the parent actually becomes the therapy. Now I am sure they don't realise how bad things have gotten. I remember taking a file to every therapy appointment I made a point to show each therapist the list of programs and activities I had been given, this was a full lever arch file as what was happening was we receive a little homework from the speech therapist, a little from the occupational therapist, then if you are lucky to have more than one child with special needs. It's all a little crazy don't ya think!! 

You'll have to forgive me, today I'm a little over it! It's incredibly discouraging asking the experts what is wrong for no-one to actually be able to help. That the majority of the time I understand my son, more than anyone else, actually no-one really knows my son truly. Something, somewhere has to change. 

Now to finish on a positive note, I am sure a lot of you have actually been here with me, so you will get me. For those who haven't been here and you wonder why we are often a bit distracted or tired, now you know why!!!

This is what is really the most important no-one and I mean no-one will get your child like you do. It sounds strange but some days I take off the therapist hat off and muck around with my kids, let them climb all over me, stay up a little later than normal. Or I take my boy riding with me for some one on one time. Laughing over what my kids find funny (usually what adults think it stylish). I snuggle up with my baby and feel her cheek on mine, ask my 4.5 year old if I am allowed to kiss him tonight or enjoy the moments when my eldest son holds my hand while out shopping not just because I told him to.  This is where it's at!

So the last few days, in my self searching I'm determined to do something a little different. Instead of being the "therapist" all the time I'm going to the therapist sometimes. In the whole scheme of things I guess I have put myself under the pressure to help my kids, the pressure from others is not necessarily what I have to be, I choose who I am and what I do. An idea I have had to make things simpler is to try and allocate times for therapy rather than allowing the WHOLE of our time together be therapy. This may be the challenge!!! 

something new - a diagnosis out of left field

So long story short.. my second son who we have been waiting for an assessment to see where things are at, finally got to see the paediatrician  So all the testing happens I know at what points he will find it hard and he does. Then she adds up the scores and development delay suddenly becomes a concern. Apparently he is around 15 months behind where he should be in 4 out of 6 of the areas of testing. We were well prepared for the speech aspect of his assessment knowing that he is not where he should be, but the rest was a bit of a shock. Then the next stage is to wait for a report from the paediatrician outlining how things are and what referrals she is making apparently occupational therapy is all that is recommended. I can't help but think is that all? There is a new label and really not a lot we can do about it yet. 

Processing this news is quite difficult I never thought that things were really this bad, I knew that there was some effects from the hearing loss that he has experienced but this much I was not expecting. Feeling a little let down or something, why wasn't this picked up sooner. Why did it take so long for the stupid referral to turn into an appointment. What does it really mean I really don't know. 

These are the things I found while doing a quick search on old faithful google:

Recognising developmental delays by Web MD I have cut and pasted the article onto my blog it was hard to read as it was split up over several pages. So you can read this all in one hit please note it wasn't something I have written.

Developmental Delay a brochure on what it means

So today the testing was carried out and my boy completed the Griffith Mental Development scale. This is used a lot by psychologists and paediatricians and can give an idea of a child's development in regards to their expected development and where they really are some more information I found on the Quirky Kid Psychological Services page

"The Griffith Mental Development Scales (GMDS) are widely used by pediatricians and psychologists to measures the rate of development of infants and young children from birth to 8 years. The GMDS assess a child’s strengths and weaknesses in all developmental areas, and can be used to determine if a child is in need of an early intervention or a treatment program.

The six areas of development measured by the scales include:

• Locomotor. The Locomotor sub-scale assesses gross motor skills, including the ability to balance and to co-ordinate and control movements;
• Personal-Social. This sub-scale measures proficiency in the activities of daily living, level of independence and interaction with other children;
• Hearing and Language. Is the assessment of hearing, expressive language and receptive language;
• Eye and Hand Co-ordination. This sub-scale focuses on fine motor skills, manual dexterity and visual monitoring skills;
• Performance. Performance assesses the developing ability to reason through tasks including speed of working and precision;
• Practical Reasoning. The Practical reasoning sub-scale measures the ability of a child (2 to 8 years) to solve practical problems, understanding of basic maths concepts and understanding of moral issues."

What now.. that waiting business again. In the meantime there isn't much I can do for now as nothing can be given or funded for until the report comes in. What do I feel? disappointed  angry, frustrated, heart broken. You dream of providing your best for your children so they succeed in life you never imagine that they might struggle for the small things. Deep down a part of me knows that my son will be OK, my situation is not as bad as some others, but it's definitely bad enough for me. 

For now I am going to do my best to do the normal day in day out stuff and let time pass, I am going to allow myself not to think all of the time about what on earth to do to fix this, or to help him or to make it better. I am not going to spend every moment looking for information or second guessing the time it took to get him help, what else I could have done.  So the program is look after myself, look after my marriage, then be the best parent I can be and somewhere in there fit in the housework! That is enough trouble for one day!

Recognising Developmental delays in your child

While reading about developmental delays I found a useful guide for recognising delays. The link to the article is in the heading
Recognizing Developmental Delays in Your Child: Ages 3 to 5

As you watch your child grow, keep in mind that each child develops at his or her own pace and that the range of normal is quite wide. However, it is helpful to be able to recognize signs of potential developmental delays in one or more areas of emotional, mental, or physical growth.

If you wonder whether your child is experiencing a delay, don't wait to find out. See your child's doctor right away. Early intervention is the best way to help him or her make progress. Unfortunately, fewer than half of all children with developmental delays are identified before starting school.

What Are Developmental Delays in Children?

There are many different types of developmental delays in children. They might have problems in the areas of:

• Language or speech
• Movement, or motor skills
• Emotional and social skills
• Thinking, or cognitive skills

Here are warning signs for different types of delays that may show up from ages 3 to 5, as well as some of the causes of developmental delays and their potential types of treatment.

Language and Speech Delays in Children

Language and speech problems are the most common type of developmental delay. Speech refers to verbal expression, including the way words are formed. Language is a broader system of expressing and receiving information, such as being able to understand directions.

Possible causes. A wide variety of problems may cause these language and speech delays, including:

• Exposure to more than one language.
• A learning disability.
• Hearing loss: Hearing may change often in children who have recurrent middleear infections.
• Autism, a disorder that impairs social interaction, or other similar disorders.

Types of treatment. If you or child's doctor suspects a developmental delay, seek an evaluation by a speech-language pathologist. This specialist may use speech therapy with your child. The specialist or doctor may also suggest that you:

• Communicate more with your child; talk, sing, encourage repetition.
• Read daily to your child.
• Reinforce speech and language throughout the day.
• Get treatment for middle ear infections.

Warning signs of speech or language delays

Contact your child's doctor if your child has any of these signs at these ages. In addition to these red flags, watch for any loss of skills already learned.

By 3 years

• Your child cannot talk in short phrases.

By 4 years

• Doesn't use sentences of more than three words.
• Uses "me" and "you" incorrectly.

By 5 years

• Has trouble understanding two-part commands with prepositions ("under" or "on").
• Cannot give first and last name.
• Doesn't use plurals or past tense the right way.
• Does not talk about daily activities.

Motor Skill Delays in Children

Delays in children may be related to problems with gross motor skills such as playing ball, or fine motor skills, such as coloring.

Possible causes. Children who have been institutionalized, lack stimulation, or have autism, may have what's called "sensory integration dysfunction." This complex disorder can cause a variety of problems with the senses, including:

• Problems planning and coordinating movement.
• Fearful reactions to ordinary movements or an excessive need to seek out sensory input, such as by rocking, spinning, or hand-flapping.
• Extreme reactions to touch, textures, or pain.

These are other possible causes of motor difficulties, although most are rare:

• Problems with vision.
• Ataxia, a defect that impairs muscle coordination.
• Myopathy, a disease of the muscles.

Types of treatment. For motor delays, your child's doctor may suggest taking certain steps at home to encourage more physical activity. Your child may also need:

• Physical therapy for gross motor delays.
• Occupational therapy for fine motor delays or sensory integration problems.

Warning signs of motor skill delays

Contact your child's doctor if your child has any of these signs of motor delays at these ages. Remember to also watch for any loss of skills already learned.

By 3 years

• Your child falls often and may have trouble going up and down stairs.
• Drools often and has unclear speech.
• Has trouble working with small objects.
• Cannot build a tower of more than 4 blocks.

By 4 years

• Cannot throw a ball overhead.
• Cannot jump in place.
• Cannot ride a tricycle.
• Cannot grasp a crayon between thumb and fingers or has trouble scribbling.
• Cannot stack four blocks.

By 5 years

• Cannot build a tower of six to eight blocks.
• Seems uncomfortable holding a crayon.
• Has trouble taking off clothing.
• Cannot brush teeth well.
• Cannot wash and dry hands.

Social and Emotional Delays in Children

Children may experience problems interacting with adults or other children -- considered social and emotional delays -- which usually show up before school.

Possible causes. Some causes of social and emotional delays include:

• Neglect, such as from early institutionalization.
• Ineffective parenting.
• Weak attachment.

Another common cause of social and emotional delays is called pervasive developmental disorder (PDD). This group of disorders also causes communication problems, ranging from mild to severe. PDD includes:

• Autism, a complex yet common disorder.
• Asperger's syndrome, a condition similar to autism.
• Childhood disintegrative disorder, which typically occurs in children ages 3 to 4.
• Rett's syndrome, which often includes mental retardation and occurs mostly in girls.

Types of treatment. There is no known cure for PDD. However, treatment may include:

• Medication to help with behavioral problems.
• Special types of behavioral therapy.

In addition, learning therapeutic parenting skills may help promote healthy attachment, and social and emotional skills, in your child.

Warning signs of social or emotional delays

Contact your child's doctor right away if your child has any of these signs of social and emotional delays at these ages. Make sure to observe any loss of skills already learned.

By 3 years

• Shows little interest in other children.
• Has extreme trouble separating from parents or caregivers.
• Has poor eye contact.

By 4 years

• Clings or cries whenever parents leave.
• Ignores other children.
• Doesn't respond to people outside of the family.
• Lashes out when angry or upset.
• Resists dressing, sleeping, or using the toilet.

By 5 years

• Is very fearful, timid, sad, or aggressive much of the time, or doesn't show a wide range of emotions.
• Is unable to separate from parents without difficulty.
• Shows little interest in fantasy play or playing with other children.

Cognitive Delays in Children

Problems with thinking and cognitive skills may occur due to genetic defects, environmental factors, disease, prematurity, nervous system abnormalities, oxygen deprivation during childbirth, and even accidents. 

Possible causes. Common causes of cognitive delays include:

• A poor learning environment.
• Institutionalization or neglect during infancy or early childhood.
• A wide range of learning disabilities.
• Exposure to alcohol or toxins during pregnancy.
• One of the pervasive developmental disorders (PDDs), such as autism.

Types of treatment. As with most types of delays, early intervention for cognitive delays can make a big difference in the progress your child makes. Depending upon the diagnosis, treatment may include:

• Medication in rare cases.
• Play therapy or occupational therapy.
• Special education.

Warning signs of cognitive delays

Contact your child's doctor if your child has any of these signs of cognitive delays at these ages:

By 3 years

• Trouble copying a circle.
• Cannot understand simple instructions.
• Does not become involved in "pretend" or "make-believe" play.
• Shows limited interest in toys.

By 4 years

• Shows no interest in interactive games.
• Doesn't become involved in fantasy play.
• Cannot copy a circle.

By 5 years

• Is easily distracted.
• Is unable to concentrate on a single activity for more than five minutes.

Remember: There is a wide range of normal development in children. Most developmental delays in children are not serious, and most children can eventually catch up. Even children who do have serious delays can make big improvements -- when treatment begins as early as possible.

Doing something fresh

Imagine if you will, heading into a confessional, in my booth is the following admission. It is difficult to keep a house clean, be a Mum to three kids two with special needs and one baby. Stay married and have time to sleep. In the past I have done flylady and I really enjoy doing that because there are a lot of things I can take on board and to be honest I always need to learn more. So... for something new I am taking a look at a blog I have been reading and doing the 20 day challenge. Why don't you join me for something fun?! So I will post a little on facebook and maybe on here about my journey but if you click on the following link it will get you started:

This is the link to the page that starts off on the pre challenge tasks 5 of them in fact before the 20 day challenge!

Organised Housewife - Pre challenge task 1

So join me if your brave enough!!! If you have a blog why not grab the code to add her logo to her page as well?

Start the year well - what to do about resolutions!

Resolutions we all make them and often we also break them. The biggest issues we can actually face are unrealistic goals usually accompanied with perfectionism or lack of self control. So what should you aim to do, should you make a resolution or not make any at all? In the theme of starting the year well consider the following:

• Don't say yes when you really mean no make a list of all your commitments, then consider all them. I was once told when you make a commitment do it for a year. Then really commit to it. Nothing worse than feeling exhausted, resentful because you really should have said no.
• Consider what you sign your kids up for this whole balance is rather difficult to work out. Think back on the previous year take note of what worked and what didn't. The balance of sport therapy and school is rather delicate. We are the gatekeepers in our house, we choose what we allow our kids to do and we are there to protect them from being over commited. 
• Think about what you have to do and do it well. Let's make our family, marriage a priority first. We want them to feel that they are our highest priority. We know we have to do housework let's make it fun and not a chore. Whatever is essential make it fun and easy for you and you will feel less stress. 
• Therapy therapy therapy for some of us this takes a big chunk of our lives. So to start the year well make sure the therapists have clear achievable goals ask them to review how your child went last well and then get a realistic idea of what you as a parent want to see happen this year. 
• Don't try and fix everything! sometimes I found too trying to fix everything is exhausting so if you need to, mark different periods of time as a focus on a development area. I also do this when it comes to discipline and behaviour with my kids I make sure that I don't overwhelm my kids by disciplining them all the time, I make a point of focusing on respect and teach on that, it really released me from a lot of stress. 
• Parents make sure you do something that is just for you this year, an inexpensive hobby, getting fit whatever it is. Doing something for you will make you a better parent over all. So allow your partner to pursue a hobby and make sure you do the same, Mums are notorious for allowing the Dad to get out and neglect themselves! You know it's true!
• Make a plan whatever it is make some plans about what you want to do as a person, parent and spouse. Take some time out and have a coffee with your spouse to sit down and talk about parenting, marriage, finances so that at the end of this year you will be in a better place 
• Start a jar this photo has been circulated pinterest and facebook. I reckon it's a great idea!

With anything we do to achieve anything takes, willpower, organisation and self control. So make sure the first thing you do is get rid of excuses that sabatoge your success. Be tough on yourself if you need to be, don't be a wuss, make it happen for you!

So this year get rid of the compulsion to make New Years Resolutions that you aren't going the keep. It stresses you out, it is unrealistic and never makes you feel good about yourself. This year be purposeful about what you are doing, so that at the end of this year you will have this jar full of awesome achievements at the end of this year. 

Starting your year well - Making your house a home

Your home, the heart of where everything starts. What do you think of when you get home, when you walk into your bedroom, kitchen dare I say it the kids playroom. It stands to reason this is something we should pay attention to as well. What can be done about it?

There are many dimensions to making a house a home. Here are a few areas to help you think about what you want to do!

• Routines, routines, routines now don't groan too loudly. I remember when I left home actually not knowing how to keep a house, I knew how to clean but I actually didn't know how to keep it clean. Since then I have been making all sorts of attempts make changes in this area. Reason being not only do I want my home a haven, I also want to train my kids in the way to keep a home as well.                 Now I won't go into this too much but to mention a few things that have helped me and may help you also. Flylady is a website that helps you starting from scratch learn routines to keep your house clean. A lot of what I have learnt has come down to the excuses and thinking that sabotages me before I get started. Another website that is simular but different to flylady is The Organised Housewife, this site has many ideas on helping to get the house into order and different freebies you can download or some that you can purchase. Both of these websites have facebook as well. What also goes well with Flylady are two apps Cozi and my favourite Home Routines please check them out!
• Being intentional  this concept is a little more abstract. What do you want people to feel when they come to your home? What do you want to feel when you go home? Recently I read a book that mentioned making our bedrooms places of retreat and relaxation, simply buying a new doona cover, pillows or candles. Maybe buying some flowers to put on your dining table. Get creative simple little things can make us feel special including those around us. Let's not forget to make our children's rooms special as well, lamps, doona covers they like or have picked out, whatever is going to make their room a haven. After all a good night's sleep for them is a great nights sleep for you too!
• Don't be a perfectionist this is my experience I always want to do the job properly it frustrates me if I can't. But in my perfectionism I realised that I actually wasn't doing the job at all. So I decided it's time to do at least some of the job, I started with cleaning the dining chairs you know the ones your kids spill weet-bix all over? I decided to just wipe them down more often and thought you know it will get clean. I didn't have to do a full detail clean. The reason why things get bad is because we don't do the little things. I think in the last three months I think my house is getting easier because I am doing something instead of staying in the prison of perfectionism. 

Whatever your personality style is, if you hate routines or not, or you get obsessed with doing the routine if you can't do it you give up. This year say no to sabotaging your efforts in your home. After all you spend a lot of time there and you deserve to feel rested and relaxed. So the challenge is have a think about what type of personality you are and then make the changes little by little to change those things into a positive. So if you hate routines then have a go you never know it might work. If you are obsessed with making a complicated routine, then make it simpler so you can achieve it! Whatever it takes do it well and then sit back and enjoy the benefits!

starting the year well - me, myself and I

Traditionally this is the time of the year for New Year's Resolutions. To be honest it can be a time where we think about where we went wrong, check out our priorities and plan to make changes. Sometimes we are so exhausted we enter the holidays with not much energy only to realise the change in routine sends our kids a bit loco!

As a parent, whether or not they have special needs or not, as a wife regardless of what state your marriage is we all need to start off with looking after ourselves. We after all a major part of other people's lives. Here are a few ideas of where to start:

• Think of the basics (sleep, eat, exercise) Now don't roll your eyes at me, I know you are saying I don't have enough time, money, help etc.. The first challenge I have for you is to examine your excuse. Does it stand to test if a friend told you the same excuse would you let them off? Maybe not? So make a point to turn the TV off earlier and go to bed, eat healthier and fit in some exercise into your weekly routine. 
• Think about the straw moments Think back to during the year and those moments were you had a mini meltdown kicked the dog, yelled at your spouse, child the list goes on. What were you thinking about, frustrated about, hurt about. Take those thoughts as a preventative. Think about how you can change the way you do things to avoid a reoccurance this year. 
• Who are you? some days it can feel like our self, identity is lost in a black cloud of confusion. Yes there are parts of you that overwhelm the rest of who we are. But if we lose sight of who we are, we can become very resentful in the long term. So this year do something for you and only you, especially something that reminds you of a passion you once had. 
• Be kind to yourself are you constantly berating yourself, I am not good enough I can never do this, I can't keep my house clean, I don't do enough with my child, I don't do enough therapy, I forget everything, I'm fat, I am not good looking. My challenge is STOP! Instead make it a practice to think about what you are doing right don't think in absolutes I never, I find doing small things to achieve the bigger goals really helps. 
• Make time for relationships if you are so busy you don't have time for people you are missing the point. This year it is one of my goals is to make more time for my marriage. So if you are in the same boat. Make a change and be intentional save time and money and set it aside for those who are important to you. Treasure those who are close to you, be nice for a change, appreciate what you have. Also think small and big, don't get overwhelmed by lack of time or money. Do simple things to say how you feel to your partner and your kids.
• Stop putting of what you need to do are there things you need to do but you aren't doing them in the name of procastination? Things like health checks, to do tasks, losing weight, paying bills, planning. Procastinating is not a positive character trait it makes more stress in your life. So start by doing something today, don't put things off make the appointments do your budget or clean that room in your house that you are dreading. The sense of achievement will make you feel much better!
• Make time for faith if you have a faith, believe in God, this is part of your life so make it happen. Read your bible, pray more often (don't get overwhelmed just do it) it will make things easier and better in the long run. 
• Use a diary or calendar in whatever form, paper or technical use it, it is going to make your life better not forgetting appointments and bills and dates!

Starting with you is the most important place, I know I am guilty of being so busy that I don't look after myself. You know the story buy your kids clothes and then forget yourself. Feed the kids and then snack yourself. So this year make it the year to stop being so hard on you and make the time to look after yourself. I made a point to start doing this last year and it is making a huge difference to how I feel and how I cope, but being a better person makes everyone around you happier as well. You will be less cranky, not as stressed out everyone wins! Check out Starting the year well - Making your house a home the next post!