‘Tickle Monster’ therapy

The world becomes invasive, and maybe even a dangerous place, to a child who lives with constant “assaults” on their personhood. Children who experience the world as unfriendly can develop emotional complications such as Post Traumatic Stress Disorder (PTSD) and they can withdraw, concluding that life appears to deliver more pain than pleasure.

Nurses are not always informed or trained about PTSD, its impact and the consequences for children with handicaps. PTSD results from experiencing trauma, overwhelm and powerlessness. Children born with limitations or illnesses who have experienced the world as having an invasive nature can develop emotional complications. Aversions to food, hair care and dental hygiene can happen because of people coming at them—especially at their heads and faces without warning or choice, during critical developmental stages where they should have developed trust but couldn’t. When people keep doing hurtful things to your body in preverbal stages, there are no words for the emotional pain and often no way to vocalize the hurt, frustration and anger that mounts in response.

Handicapped children are resilient, but that doesn’t mean they don’t have scars from the assaultive nature of early treatment and intervention for a severe illness that intrudes at the beginnings of life. It can affect and even derail the development of trust. Giving a child as much control over their environment and circumstances as possible helps to mitigate the helplessness and powerlessness they feel about their lack of autonomy. Reframing the context can prevent further trauma.

Maddie and I make a game of most of the daily frequent and necessary stretches, range-of-motion, massage and exercises that keep her body from freezing up due to lack of movement. We play a game firmly counting fingers to accomplish joint compression for normal bone development. To apply lotion for massage, she requests “ploops,” which delight her with sound and feel as the lotion in the bottle cascades and plops onto her belly in preparation for her massage.

We play “What’s this?” with all of her body parts while with my help she points to her chin, cheeks, nose, mouth, eyes, ears, forehead, hair and so on, and gets her range of motion accomplished. We massage her quads, knees, hamstrings and heels, and then we chant “Boogie-oogie-oogie ’till you just can’t boogie no mo’” while her knees and legs are pulled up to her belly and back down. Then she asks for “Around!” and we chant “’Round and ’round and ’round she goes and where she stops nobody knows” while spiraling motions move her legs around her hip joints, lubricating the sockets and promoting muscle optimum retention. The daily routines help to keep her current level of mobility and range of motion intact and help to prevent contractures—body parts becoming “frozen” from disuse.

There comes a time in our routine when we “shimmy” to shake the shoulders in order to maintain and maximize her muscle control with movements she can make herself. I began by singing an old ’60s song: “Shimmy, shimmy cocoa bop; shimmy, shimmy bop!” while shaking my shoulders in a shimmy to demonstrate the movement to her. Maddie now sings this song herself and independently shimmies her shoulders. Since her newfound appreciation of the word “no,” it has become necessary to try reverse psychology, telling her, “No, don’t you do cocoa bops! It’s MY turn!”—in which case she immediately begins to shimmy and sing. I then call her “Stinker-belle” instead of Tinker Bell, which sends her either into giggles or protests, depending. And that, of course, necessitates the arrival of the “claw,” which is a hand that crawls slowly up her feet, legs and torso like a spider, and ends up spanning her face in a “gotcha”!

The Tickle Monster –>