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Q: My five-year-old daughter has been having these uncontrollable fits every time she is overtired. I refuse to give her a nap because she will be up until 10:00 PM. She causes herself to cough excessively, and I cannot seem to calm her down. I have tried placing her in her room, sitting her on the couch. I think she is being a typical five-year-old trying to grow up. Do you have any suggestions on how I can avoid this 6:00 PM every-night occurrence?
A: It is really common for kids to want to rest part of the late afternoon, after what has been to them a long, active day. Kids have so much energy and are usually busy all day. Letting your daughter rest or even sleep for a short period of time, maybe only 30-45 minutes, may in fact be just enough so that she does not act overtired. Although this is not meant to disrupt her normal sleep patterns, this can be particularly problematic because of the time of day--you may be trying to prepare dinner and other family members may be coming home after their day activities.
Not letting a child nap can be a difficult battle to win. The excessive coughing and being unable to calm her down are certain to get at least some of your attention. Time-out technique doesn't work effectively when its purpose is to change a natural behavior. Having her sit quietly--turning pages in a book, playing a low activity game, or watching a movie or TV show--may help. It may be easier to look at the rest of her day, in the earlier hours, and see whether some adjustments there may make the evening hours more tolerable for everyone.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.