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Getting on with others

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Why we need others

Getting on well with other people (relationships) is important to us all. Good relationships make us feel secure and valued. This helps to build confidence and self-esteem. The relationships children have with their families, friends, teachers and carers are important in helping them grow into confident and happy adults.

Most of us share our experiences in life with other people: we share happy times and sad times; we can be serious or silly. Sharing good and not so good times with other people helps us to learn. Realising we are not alone and having someone to talk to when we are sad, confused or unwell can help us to feel better. It can also teach us how to deal with many situations that we face in life. Sharing laughter and fun makes life happy and enjoyable.

Children with hydrocephalus sometimes don’t find it as easy as others to build strong relationships. This section looks at things that make relationships difficult for them.

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Poor Health

Learning how to have good relationships starts from the moment we are born. It starts with being close to our parents. Someone with hydrocephalus or a related illness may need regular hospital care from very early in their lives. This can be distressing for parents and their child. It is very important for new babies to create strong bonds with their parents. Time in hospital may make this more difficult.

As a child gets older, long or regular stays in hospital can result in missing school. The child may not be able to join in other activities such as groups or clubs (eg sports club, Scouts or Guides). It can also be more difficult to pick up with friends after a long time in hospital, for example. Missing things at school or chances to join in groups might make a child feel different from their friends. It might also make other children think they are different. All or any of these things might stop your child from joining in and building relationships.

Example 1

Peter, aged 12, had missed six weeks of school due to being in hospital. He was really fed-up because he was missing the table tennis competition. He was also a bit worried about all the work he had missed and he didn’t know what he’d say to his friends. In fact, the more he thought about it, the more he realised he didn’t really want to go back to school at all.

Peter’s Mum contacted his school and together they arranged a few things:

  • They arranged for someone at the table tennis club to bring photos of the games and share some of the highlights with Peter.
  • As he got better different friends would pop in with bits of school work for him. Mum turned this into a social thing too by getting in pizza or a DVD for after.

After a few more weeks Peter was ready to go back to school and he didn’t feel so bad about it. He knew he still had some work to catch up on but he’d seen his friends and they helped him feel less worried about this.

Parents are very protective of their children when they are ill. Quite often they don’t want too many people visiting or popping in. But, including relatives and friends in a child’s recovery will help to cheer a young person up. This will help them feel more confident about getting back into daily life.

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They just keep talking - ‘Cocktail Party Syndrome’

Sometimes a child or young person with hydrocephalus appears to show great language ability and seems sociable, agreeable or charming. This can be thought of as advanced or adult type behaviour. Often however, the child or young person’s language abilities are not matched by how well they manage in school or with day to day tasks at home. They may still seem to struggle to get on with other children and may seek adult company rather than be with children their own age.

The ability to speak clearly and fluently can mislead others into thinking that a child or young person with hydrocephalus can cope much better than they actually can. Sometimes these young people have lower than average abilities but on the surface look very able. Things that might show that the child is actually having difficulty are:

  • Use of clichés or well-known phrases (from a favourite programme perhaps).
  • Use of words / phrases that don’t quite fit with the context.
  • Use of words that the young person doesn’t know the meaning of.
  • Lack of logic in what is being said.
  • Inability to change in line with the conversation.
  • General lack of awareness of other’s responses / input / signals to stop, change or move on.

The ‘cocktail party syndrome’ may be a problem with self-expression in the sense that what is said can be misplaced or irrelevant. Sometimes it is difficult to get a child to stop when they are in this mode. This can be difficult to manage and some may find it embarrassing or irritating. It can also be confusing for other children who might avoid or stop playing with someone who talks in this way. See flexibility in thinking and doing for hints and tips on how to deal with situations where a child seems to get ‘stuck’.

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Understanding what is going on

Good relationships rely on good communication. This doesn’t just mean listening and talking. It means understanding what you hear. Sometimes a child or young person with hydrocephalus has problems putting all the words and sentences of a conversation together to make sense of it. Or things might just happen too quickly for them to follow.

When we chat we also pick up on clues that tell us how another person is feeling. The clues might tell you whether the other person means what they say, or they can signal whose turn it is to talk. These can be little things like: changes on a person’s face or the way they are standing; they may make hand gestures or move in a certain way (like impatiently tapping a foot). Some people are more sensitive to these unspoken clues than others.

People with hydrocephalus can misread a situation because they don’t quite understand what is said or they miss some non-verbal cues. This might mean they say or do the ‘wrong’ thing. This can puzzle other people or make them angry.

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Being ‘bossy’ or ‘pushy’

A child or young person with hydrocephalus can sometimes be said to be ‘bossy’ or ‘pushy’ or ‘only doing things on their own terms’. Sometimes their desire to talk is seen as a way of avoiding doing as they are asked. Acting or behaving in these ways might be because the child or young person is struggling to understand or comprehend what is happening or what they are being asked to do. It may be ‘covering up’ or masking their difficulty and anxiety. It may take longer for a child or young person with hydrocephalus to understand what they are expected to do in different situations.

When a young child is a little ‘cheeky’ it is often thought of as ‘cute’ or ‘funny’. When an older child shows similar behaviours it tends to be frowned upon. Generally it is thought that they should understand the ‘social rules’ better. They are expected to have ‘moved on’ and know how to behave or follow instructions. A child or young person with hydrocephalus may continue to find social situations difficult and they may have trouble getting on with others. The links in this passage will take you to pages where examples of these behaviours and hints and tips to help are provided.

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Playing alone/not mixing

A child or young person with hydrocephalus may tend to play alone or not mix with others their own age. They may spend more time talking to adults often in one to one situations. There can be different reasons for this:

  • They might find it difficult to keep track when there are lots of things happening with lots of people. One to one conversations tend to be slower and easier to follow.
  • They may be aware that they make mistakes and this makes them uncomfortable or anxious.
  • They may feel ‘different’ and feel that other people see this too.
  • Other children may find it difficult to get along with them for some of the reasons shown above.

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Socialising at school

Schools are busy places. Most socialising happens in the dinner hall or the playground where it can be noisy. It may not be obvious to others that a child or young person is having problems socialising. They may manage very well when speaking to an adult, in the classroom or in very small groups. Often they seem to be very talkative and to be having fun.

If a child or young person finds these busy and noisy situations difficult they may avoid them. Perhaps they may make so many mistakes that other people start to avoid them. This can be upsetting for the young person and their family.

Example 2

Aryan, aged 9, was a lovely boy: very cheerful and always chatting. His teachers couldn’t understand how he kept getting into trouble in the playground. One minute he’d be running around the playground laughing with the others. The next he would be squabbling with one of the other children. The other children seemed to go from enjoying playing with Aryan to giving him the ‘cold shoulder’. Occasionally they would call him names and this really upset Aryan. He would sometimes hit out and would get into trouble from a teacher.

Ms Graham decided to watch what was going on. After a while she realised that sometimes the children would make up new rules for their games. She also noticed that Aryan didn’t always follow the new rules and the other children would get upset with him. They seemed to think he did it on purpose. At other times Aryan seemed ‘bossy’ and took charge of the game. The other children didn’t like this either. Ms Graham decided to take action:

  1. She found some stories about working together and supporting friends.
  2. She set the children some ‘puzzles’ where they had to work out how to make decisions as a group.
  3. She set up a buddy system and gave lots of thought to who might help Aryan most.
  4. She talked to Aryan and his buddy about things they each found difficult and how they could help each other (being careful to ‘help’ them to talk about how Aryan could enjoy new games).
  5. She helped Aryan’s buddy think of ways to help, like getting Aryan to copy him, or taking some time to watch the game first.
  6. She helped the group work out how they could take turns at being in charge.
  7. She also helped them think about what they might do if Aryan did make a mistake.

Aryan’s buddy has been really good at helping Aryan to stay on track. Ms Graham has had to swap the buddies around a few times but this has really helped lots of the children to understand how to work together and include everyone. There are still a few squabbles but then, there always will be!

Any child or young person may find it hard to solve tricky social situations but this will change with age. A child or young person with hydrocephalus who seems out of step with their friends may have some of the difficulties listed below.

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Getting picked on/bullied

A child or young person with hydrocephalus may have difficulty keeping track and they may make mistakes in social situations. This sets them apart from the group: they appear different. Being different may be all that it takes for other children to start teasing. Teasing can become uncomfortable and hurtful. Sometimes children work out who can be ‘tricked’ or more easily led (manipulated). A child or young person with hydrocephalus may have problems working out what’s happening in a situation. This may make them an ‘easy target’ for a prankster.

All children need to learn tolerance and appreciate differences. Some will be more able than others to do this. Sometimes children who pick on others have problems of their own. Sometimes it’s a way of feeling stronger or more important. It is unlikely that you can tackle those issues but you can work with your child’s teacher to look for ways of encouraging more cooperative behaviours in school. Offering support and guidance to your child will also help to give them confidence to cope with difficult situations.

Example 3

Lisa, aged 14, used to enjoy drama club. She talked a lot about what they had done and any projects they had planned. Quite suddenly Lisa stopped wanting to go and wouldn’t explain why. A few weeks after this she started to complain about headaches a lot and wasn’t keen to go to school. Lisa’s Dad took her to the Doctor (just to check) but everything checked out OK.

One evening Dad was sitting with Lisa watching TV. The programme showed someone being teased and bullied and dad noticed that Lisa seemed very uncomfortable. He asked her some questions about what she thought of the programme and they talked about bullying. Dad was pretty sure he’d worked out Lisa’s problem but he just made it clear that she should always feel free to talk about anything upsetting that happened to her.

Within a few days Lisa spoke to her Mum and Dad about a new girl at school and drama club who had been making her feel really bad. They talked about how the bully was in the wrong and that this shouldn’t stop Lisa doing things she enjoyed. Together they talked with Lisa’s drama and guidance teacher and worked out a ‘support system’ around school and at drama. This allows Lisa (and others) to avoid the bully. When they do encounter her, they have the strength to walk away and ignore her. Now, Lisa can talk to her friends when she feels upset because they understand what’s been going on.

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This page has so far talked about how a child or young person with hydrocephalus might find it difficult in social situations. But, sometimes a parent or carer might be concerned that a child is getting on too well with others, perhaps strangers. We have discussed how ‘talking too much’ or being ‘forthright’ or ‘pushy’ can cause problems in situations where we would like children or young people to get on better. These things can also be inappropriate even when the outcome seems positive i.e. the child is happy and getting along with the other person just fine.

Parents and carers can find this difficult for various reasons:

  • They might worry about safety (e.g. concern that their child might talk to anyone).
  • It might be embarrassing.
  • It might be poorly timed (eg while the lollipop person is trying to helps lots of children cross the road).

The concerns of parents and carers might be different but the reasons for the inappropriate behaviour are likely to be the same. A child or young person with hydrocephalus may make mistakes about when and how to behave in certain ways. This is often to do with noticing interest or friendliness from others but not being able to judge the situation as a whole. Knowing how to behave in different situations may be more difficult for someone with hydrocephalus.

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Why social situations can be difficult (what happens in the brain)

When a young person with hydrocephalus seems to spend a lot of time on their own we may wonder why. They may not seek company outside of school or they don’t have friends that call or come to play. Socialising can be difficult for a number of reasons. A young person with hydrocephalus may:

  • Struggle to notice many non-verbal cues.
  • Be unaware of distances and so may seem to ‘invade’ another’s personal space.
  • Have difficulty understanding (or conceptualising) things that are said.
  • Be unable to keep everything that is said in mind or keep track of what is being said.
  • Be unable to work out what is important and find the best way to answer or act.
  • Find it hard to plan their responses or spot when they have made a mistake.
  • Have difficulty finding the right words or actions to express themselves in the right way.
  • Get stuck saying or doing the same things over and over or at the wrong time and place.

Feeling like they are ‘on the spot’ and a combination of processing difficulties above can result in someone with hydrocephalus giving inappropriate responses. Some children and young people benefit from practising conversations and memorising phrases to help in commonly occurring situations.

The links above will tell you more about what is happening in the brain to make these different things happen. A combination of difficulties could make it hard for a child to have positive relationships. The child could become isolated. It may have an impact on their confidence and self-esteem. Problems with communication can cause every day misunderstandings, even with loved ones.

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Want more hints and tips?

Some of the difficulties seen in children with hydrocephalus are also seen in children with other conditions. This does not mean that a child with hydrocephalus has another condition. It just means that the brain may have been changed in similar ways. So, some hints and tips might also work for a child or young person with hydrocephalus. You can find useful ideas in these sites:

Social skills in young children (

101 ways to teach children social skills (Social Skills Central)

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