Advice & Support

There's a nice piece on Babble today about how to tell when a child's tantrum is just a kid being a kid—using the weapons at his disposal to get his way on something—and when it's something more than that. The Child Mind Institute's Dr. Matthew Cruger lays out eight signs that a meltdown isn't just manipulative, but is the result of a child experiencing overwhelming anxiety.

Signs of atypical development run the gamut from tantrums that have no cause that's apparent to you to tantrums that you can't stop, even if you've given in on the issue that triggered it in the first place.  Dr. Cruger gives lots of examples of kids' behavior, and how to tell if it's something a child is using to achieve something ("diplomacy by other means," to paraphrase military theorist Carl von Clausewitz's definition of war), or something he can't control.

The American Academy of Pediatrics (AAP) yesterday released new guidelines on "screen" use for kids under the age of two—television, computer, iPod, iPhone, iPad, etc. Well, they're pretty much the same as the old guidelines, with some concessions to the ubiquity of digital devices in the modern home: keep your kids away as much as possible. 

What's the big deal? Although there has been some research suggesting a possible link between early exposure to electronic media and attention problems later in life, most professionals say what we're sure about is that children glued to a screen aren't doing other necessary tasks of development. These include interacting with and learning from other people, and engaging in imaginative play. Matthew Cruger, PhD, a neuropsychologist at the Child Mind Institute, agrees, and thinks it goes a little further. "I see this in my own daughter," he says. "TV is fast-paced and stimulating, but it's not at her level of comprehension and it's not adjustable. When parents interact with kids they can slow it down so that there's a back and forth that's really meaningful. Many parents could slow down their interactions even more to move at their child's pace, but you certainly can't get that adjustment from a screen."

Even "educational" videos are of no benefit (and are possibly detrimental) to the younger set, as they "have no idea what's going on" on screen, a psychologist tells the New York Times. And screens don't just impede a child's engagement with developmental tasks; they also distract parents from spending necessary quality time with their kids.

The screen industry was quick to respond to the recommendation, of course. "We believe that parents should be actively involved in determining the media diets of their children," a spokesman for the Entertainment Software Association tells the Times. Hey, we agree. According to the AAP, that diet should be just about as frugal as possible when it comes to kids under two. And we find ourselves agreeing there, too.

Check back soon for a childmind.org continuing series on raising children in the digital age, "Parenting 2.0."

Michaela Searfoorce, who blogs with insight and candor (and did I mention humor?) about being the mom of a child with special needs, also organizes events to help other parents in the New York area, where she lives.  This week she writes on thefoorce.com:

"I have lost count of the times I have thought to myself (or said aloud), 'What are you thinking about?' or 'What were you thinking?' or 'What are you doing?!' or 'Whywhywhywhywhy?' about something James has said or done (or not done)."

With that in mind, Michaela has invited Lydia Wayman, a 23-year-old author, speaker, blogger, and advocate from Pittsburgh who has autism, to talk to a group of parents on April  27th. Lydia has written a new book called Living in Technicolor: An autistic's thoughts on raising a child with autism.  Here's a great sample of her advice for parents on autismspeaks.com. Michaela needs enough advance registration to make the event happen. Here's where you can find out more and buy tickets for $15.

Here's an irony that says a lot about the moment we (and our kids) live in: Yesterday the Huffington Post put up a story about a gay teenager in Ottowa who killed himself because he was depressed, lonely, and bullied at school. By this morning it had been recommended by 24,564 people, shared by 8,506, and emailed by 646. By the time you read this the numbers will be higher. Jamie Hubley, the 15-year-old son of a city councilman, left a blog called You Can't Break... When You're Already Broken that expressed his misery and frustration in heartbreaking detail. Thanks to electronic media, many thousands of people, maybe millions, are now feeling his pain. But the empathy of people all over the world who don't think a teenager who is gay is "broken" didn't reach Jamie before he took his life.

That's partly because he was profoundly depressed, which he describes rather vividly: "I hit rock f***ing bottom, fell through a crack, now im stuck." But it's also because we live locally, not globally or virtually, and teenagers especially are hypersensitive to the attitudes of their immediate peers. Jamie was aware of the "It Gets Better" campaign, but things weren't getting better fast enough for him. "I dont want to wait 3 more years, this hurts too much. How do you even know It will get better? Its not."

One of Jamie's friends tells the Ottawa Citizen that he seemed happy, "was always smiling and giving everybody hugs in the halls." But she also knew he was desperate "for someone to love him for who he was."

Since teenage suicides can be contagious, we hope the message will be how terribly important it is to pay attention to signs of depression in adolescents, even if they seem to have too much going for them to succumb to hopelessness. The global response to this boy's suffering won't help if people don't learn to care locally.

Everybody's laughing (or crying) over the video of the one-year-old baby touching and swiping a magazine page, trying to make it behave like an iPad. It's pretty funny, or sad, if you buy the parent's interpretation: "For my 1-year-old daughter, a magazine is an iPad that does not work. It will remain so for her whole life."

Of course there's no reason at all to draw that conclusion, notes Susan Schwartz, MAEd, the director of our Learning and Development Center. Touching things is a natural part of development for one-year-olds, who are learning to manipulate their environment and imitating things they see others do. Electronics fit both categories, so, yeah, babies will take to them. But so do books, if their parents read to them regularly, and talk to them about the pictures they're seeing, and the stories they're hearing, so babies will learn to turn pages, too. As the parent writes, "Steve Jobs has coded a part of her OS," but there's plenty of space left.

What counts is the learning children do when parents read to them—from a book or an electronic device—which is extraordinarily important to becoming "good readers, thinkers and communicators," as Schwartz puts it. Children are exposed to an enormous number of words through parents reading to them, not to speak of a desire to read themselves. So it's cute and funny to see this digital native's surprise encounter with old media, but it's not really The Death of Print.

Anorexia is an elusive killer. The mostly young women who have it are literally starving themselves because of a distorted body image. Often very accomplished students and athletes, they nonetheless find their worlds more and more focused on a few morsels of the food they feel they must deny themselves.

Anorexia is elusive because it's hard to treat; the longer the brain is starved the more accustomed it becomes to that state. But it's also elusive because you don't have to look dangerously thin to become a casualty: starvation disturbs the chemical balance in the body and can cause the heart to shut down without notice. And those who have anorexia long-term have an appalling suicide rate; often their ability to take pleasure in any aspect of their lives is destroyed by the disease. This is the backdrop to a painful story in the New York Times today on the battle to persuade health insurers that inpatient treatment for anorexia should be covered. It's expensive, and it's not always the preferred treatment, but it also saves lives. In many places, there aren't viable alternatives. It's worth reading the particulars, in part because this is a battle for an understanding of how serious, how "real," if you will, anorexia is.

As the young woman involved in a big California test case, who was 35% below ideal  weight when she checked in to residential treatment and soon needed a feeding tube, puts it: "I don't think I would be alive today if I hadn't gone there." Don't let anybody tell you we aren't already rationing health care.

The New York Times has invited a group of 5 psychiatrists, educators and journalists to offer opinions on the subject of why more Americans are diagnosed with ADHD than in any other country, and whether we are misdiagnosing—and mismedicating—kids who are just typically active and distractable.

Several of these pieces make interesting points; two make arguments that are frankly disturbing.  Essentially they argue that the behaviors associated with ADHD—hyperactivity, impulsivity and inattention—are the result of bad teaching and bad parenting.

Donna Ford, a special education professor, argues that black boys are disproportionately labeled ADHD "as a product of prejudice and discrimination."  She gives the boys-will-be-boys defense a racial twist, charging that teachers, predominantly white and female, just don't know how to handle "culturally and racially different students."  She concludes archly: "We end up with white female teachers working with black male students. So who is the 'problem' when it comes to subjective labels of what is normal or abnormal?"

Then comes Dr. Peter Breggin, a psychiatrist, who adds parents to the list of those who are at fault. Dr. Breggin says the diagnosis itself is fake, and that ADHD symptoms are caused by "boredom, poor teaching, inconsistent discipline at home, tiredness and underlying physical illness."  ADHD, he says, "is almost always either Teacher Attention Disorder (TAD) or Parent Attention Disorder (PAD).

I'm not going to disagree that some kids may be misdiagnosed, and I would certainly agree that there are effective teaching and parenting techniques that can improve behavior in very disruptive children (we teach them in Parent-Child Interaction Therapy and Teacher-Child Interaction Training). I've heard parents call them "life-changing."  But to argue that these parents or teachers have "created" these symptoms in the first place is outrageous.  Remember when autism was the result of "refrigerator moms"?

And one more thing:  I would strenuously disagree that diagnosing a child—black or white—with ADHD is a negative thing. If a child is unable to function in a classroom, it's critical that that child get evaluation and treatment, rather than being ignored until he drops out, or allowed to disrupt the classroom and undermine learning for everyone, or being warehoused until he ages out. A diagnosis is a starting point for real help, not a label used to discriminate.

There was a lot to love on last night's Parenthood, including a prominent storyline about Max and the social challenges his Asperger's syndrome presents. The episode picked up from the previous week's lunchroom fight between Max and his younger cousin Jabbar. When Max's parents, Kristina and Adam, told him the punishment was to eat alone in his classroom for a week, his response rang true for parents and adults with AS alike. He protested that it was unfair that he was getting a harsher punishment than Jabbar, and the way the literal-minded Max told his dad to stop telling him to "suck it up" ("You know I hate expressions!") and then slap Adam's arm away when he attempted to console him were all too familiar.

But there were plenty of raised eyebrows over the idea that Max's school would discipline the potentially volatile, just-mainstreamed Aspie by having him eat lunch alone, with no teacher in sight. "In our district, they'd make Max eat in the principal's office," Nancy Peske posted on Facebook. (She "cut the writers some slack" for having Max's older cousin Amber sit with him.) Another mother who had worried about transitioning Max from a special-needs school in the first place spoke for many when she asked, "Is there no psychologist?"

Many parents of special-needs kids could relate to a desperate Kristina asking Amber to keep Max company and help him write a mandatory apology letter to Jabbar. Amber turned out to be a perceptive, accepting teacher as soon as she realized that getting a sincere apology out of Max was going to take a long time due to his trouble understanding exactly how to do it, or the real reason behind it: saving his friendship with Jabbar. "Aspies don't always make the associations that are necessary for relationships to work," another mom said, "and not everyone is going to take the time to explain it to them." In fact, it was Amber's willingness to do just that that made her Landon Bryce's favorite character in his rave Parenthood review at thAutcast.

There was also quite an "aha" moment when it became clear that Max really couldn't detect the vocal nuance that makes for a "genuine" apology. "I cried because I know my son would have a tough time making an apology sound sincere," one mom said.

Finally, Max insisted on reading his apology to Jabbar in the midst of a delivery-room celebration. Those with Aspie kids thought it was spot on, if awkward. "It felt so right to me!" one said. "I could easily see how, in Max's view, something like that had to happen just then. It didn't matter that something else huge was happening in the room." So Max read his lovely, heartfelt apology, Jabbar accepted and everyone was thrilled–especially Amber, who may have found her calling. "Amber shows real talent for working with children with autism," Peske noted. "What's her secret? Listening. Observing. Without judgment. Clone her!"

The teen years can be very tough, in part because kids are tough on each other, and in part because they are tough on themselves. Making kids feel more comfortable admitting when they struggling is the goal of an organization called LETS. It stands for Let's Erase the Stigma Educational Foundation, and the goal is to get kids talking about the mental health issues that most affect them, including bullying, eating disorders, and substance abuse. The group sponsors clubs in schools all across the country, to start open and supportive conversation while kids are as young as middle school.

Now we hear that the Friends Seminary School in New York City is one of the latest schools to join the campaign, and they will be getting a $1000 grant to kick start their club tomorrow. For more information about starting your own club visit www.lets.org.

On the bus this morning, I sat down near a mother and her four- or five-year-old child. As they settled in, I thought I heard him chirp, "Periodic table!" She handed him a muffin, and I chalked it up to early-morning delirium on my part. But as I continued to eavesdrop I heard a lot of numbers and that telltale word: carbon.

What followed was actually quite interesting: The mom was reading from a storybook of sorts that included the tale of a metal cup, its constitution, why alloys are important to everyday life, the bad "reputation" of certain elements.

Sounded like a cool book, and I couldn't help thinking that they say the most reliable predictor of a child's educational progress is not either parent's educational attainment, but the mother's educational ambitions for the child. Here's a mom who wasn't wasting a bus ride (or talking on her cell to someone else): they were having fun together and she was feeding him information along with the muffin. But when she read aloud that nitrogen has an atomic number of 7 and the boy enthusiastically called out, "Seven!" I was reminded that kids are kids, and we should never forget where they are in terms of development. I found myself hoping that the youngster wouldn't be facing a quiz at day's end.

Image from Flickr user p.Gordon