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The Child Mind BlogBrainstorm

  • Sarah Ferguson on Girls and Self-Esteem
    Dec. 3, 2012 Caroline Miller

    Sarah Ferguson, Duchess of York, stopped by the Child Mind Institute this morning to learn a little more about what we do and talk a bit about an issue of special concern to her—helping girls develop healthy self-esteem.

    Ferguson and KoplewiczSarah is appealingly frank and she talks rather disarmingly about her own struggles with self-esteem, especially when she was a young princess being ridiculed by the British tabloids as  "fat, frumpy Fergie" and "The Duchess of Pork." "I lost all my self-esteem, I lost any confidence I had, I lost myself, completely," she said, "and I don't want any girl to have to go through that. So I focus a lot of my attention on building self-esteem at a very young age."

    She empathizes with young girls who compare themselves to "stick-thin" models and feel inadequate. "I had that with Diana, who was stick-thin, and I was always the one running behind with the rather large backside," she said.

    She talks about the importance of parents listening to children and taking their fears and frustrations seriously, and letting them know that you love them "completely as they are."

    She also talked at some length about discovering that her daughter, Princess Beatrice, is dyslexic. Beatrice was 7 years old when she seemed to lose her joy, feel ostracized at school, become introverted. Sarah thought at first that her daughter might have been targeted by bullies because she was a princess, but a very good teacher, she said, explained that Beatrice was struggling with reading and not being able to keep up with the other children. With special help in school, Sarah said, Beatrice did well and has recently finished college.

    Sarah supports many different efforts to help children and has published quite a few children's books, including her latest, Ballerina Rosie, about a little girl whose red curls are always "squeaking out of her bun" and whose tutu is usually askew, who thinks all the girls in her ballet class are perfect except her. Suffice it to say that a shot of confidence comes her way, compliments of the Duchess.

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  • 'Far From the Tree': Parenting Children Who Are Different
    Nov. 30, 2012 Caroline Miller

    Andrew Solomon's new book, Far From the Tree, about parents of children who are dramatically different from them—or, perhaps more to the point, different from what the average parent hopes for or expects in children—is being reviewed, annotated, discussed and dissected all over. Book reviewers have applauded it for offering a candid and often surprising look at parents' struggles to accept and passion to protect children with "differences" ranging from autism to Down syndrome to dwarfism; kids who are gay or deaf or prodigies or killers.

    The aggregation of these various (and arguably radically different) challenges to parenting is provocative, and critics have found it very affecting. Dwight Garner, the often-acerbic New York Times book critic, calls it "knotty, gargantuan and lion-hearted."

    But to me, what's especially interesting are responses and recollections from parents for whom the emotional landscape Solomon is exploring is intimately, sometimes painfully, familiar.

    Slate offers an intense essay by Cristina Nehring, a writer and single mother of a girl with Down syndrome who seconds some of Solomon's conclusions: "Hard love is in no way inferior to easy love," she cites, and "Diversity is what unites us all." But she takes issue with others, including the idea that the prospect of a limited future leads to "chronic sadness" in parents of children with Down syndrome. "I find it leads to "chronic carpe diem"—a chronic desire to seize the day and wring the best possible from every moment—and from myself."

    It bothers Nehring that Solomon echoes the notion that while autism is mysterious, Down syndrome is not. "Autists are prodigies, introverts, misunderstood; people with Down syndrome are just dumb and dull," she writes. "And yet, Eurydice has always been mysterious to me." And she adds about her daughter, "The joy Eurydice takes in each detail of life is the most infectious quality I've ever known."

    In a sometimes painfully honest piece in the National Journal, Ron Fournier, a veteran Associated Press reporter, offers a very different take on his relationship with his autistic son Tyler. Fournier's journey starts with his frustration and disappointment that Tyler is terrible at sports—which had been his only real model for father-son bonding—and his admission that he was upset at Tyler's typically Asperger's behaviors. "I was not just embarrassed about Tyler's manners; I was embarrassed about being embarrassed." He was also upset when the psychologist who diagnosed Tyler at 12 said that he was also depressed. He was sad and socially isolated, and "mortified about his failure to live up to my expectations," Fournier writes guiltily. What's sweet and funny about this piece is the role that two presidents—George W. Bush and Bill Clinton—play in teaching this former White House reporter how to be a better father to a son who has fallen, or maybe just landed, "far from the tree."

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  • Sandy Isn't Over: View From the Rockaways
    Nov. 12, 2012 Harry Kimball

    Yesterday I stood on Beach 95th Street in the Rockaways amid drifts of sand, piles of sodden insulation and sheetrock, and discarded furniture. The apartment behind me smelled of developing mold—I knew because I had been inside tearing down walls in the hope to save the building from being totally contaminated.

    Across the street, people from all over the region had come to offer food and supplies, and cars and buses filled the parking lot that until recently had served the beach, now in ruins. Hundreds of people in shirts advertising their membership in church groups and relief organizations went from home to home, offering help. On Saturday, when I asked a guy I was working with where he lived, I expected the answer to be Brooklyn, say, or Queens. "Virginia," he replied.

    If you are in the Rockaways, or on Staten Island, or in hard hit parts of New Jersey or Long Island, you can see that Hurricane Sandy isn't over though the winds have passed. These neighborhoods are not yet in recovery. Ripping down walls to arrest the spread mold even as heat and hot water and electricity are absent and the temperatures drop is not recoveryit is a desperate measure.

    Through all of this, parents are trying to protect their children and keep life from becoming totally alien. (This jibes with our own Dr. Jamie Howard's advice for parents following a traumatic event, which you can watch here.) Kids on the Rockaways are going to schoolmaybe not the shuttered buildings out there, but keeping routine nonetheless. I saw young people pitching in to dig out cars and houses from sand drifts, giving purpose to a time that could easily inspire doubt and dismay. Even as I saw adults understandably at their wits' ends, I saw kids who demonstrated just how resilient kids can be, particularly when their families and their community are standing strong behind them.

    The homeowner others and I were helping yesterday had a three-week-old daughter, and he was determined not to have anything in their home that could harm her. Her name: Sandy. I'm sure she'll be a force of nature.

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  • When Mom and Dad Disagree on the Diagnosis, or the Treatment
    Nov. 12, 2012 Caroline Miller

    Bronwen Hruska hits a nerve with a piece in Psychology Today on how difficult it can be for parents to agree about whether a child needs psychiatric help, especially medication. "As soon as you have two parents making a decision as emotionally charged as medicating a child, you're bound to have disagreements," she writes. "It appears that, in many cases, these disagreements are straining marriages to the breaking point."

    Hruska has written about her own experience of being pressured by her son's teachers to have him evaluated for ADHD and start taking Ritalin, largely because the school felt that he wasn't performing up to his potential—in the third grade.

    In response to that  piece, she heard from dozens of parents, many of whom talked about the strife the issue was causing in their marriages.

    "When couples fight," she writes, "it seems to almost always be the men who are against medication. Not that there aren't many women who wrote to me expressing a deep discomfort and refusal to medicate, but in icy spousal standoffs, the roles were pretty clear."

    She's talking specifically about ADHD, but I would add that we see the same pattern in parents with children all over the diagnostic map: mothers seem more inclined to see a problem, a need for a diagnosis, a need for intervention—whether it's medication or something else. That could have to do with temperamental differences between men and women, which Hruska explores, or with the fact that mothers often spend more time with the child, hence might be more tuned in to cognitive and emotional differences, and experience more frustration with a child's behavior.

    This certainly deserves more attention. But the most disturbing point she makes, to my thinking, is that when parents are polarized, neither is able to acknowledge that some of the opposing parent's perceptions are valid. "In my own case," she writes, "I was scared of voicing my many doubts about medication, for fear it would weaken my 'position.' "

    When an oppositional situation makes it impossible for both parents to respond in a nuanced way, the child is the loser.

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  • Sandy and Election Day: If You Can, Vote
    Nov. 5, 2012 Harry Kimball

    Here in New York City, one of our most beloved annual traditions, the New York City Marathon, was cancelled because of the ongoing deprivation and devastation caused by Superstorm Sandy. When the storm first struck, the mayor and the marathon's organizers vowed that the 5-borough race would go on planned, as a sign of resilience. But their initial optimism was outstripped by the reality, emotional as well as physical, that too many people in the area are still suffering, without power, heat, and in many cases, homes.

    Today we are on the eve of another civic tradition, but it's one we cannot cancel because it is the very basis of our civil society: Election Day. 

    In our area there are many for whom voting will be an arduous if not impossible task. If you're holed up in a cold apartment on Staten Island, it will be tempting not to make the effort, especially if your usual polling place is waterlogged and dark. If you're a Long Island family that lost your home, expending precious gas to get to the polls might not seem a high priority.

    As always, our kids are here to provide inspiration. A colleague who lives in hard-hit coastal New Jersey told me that yesterday she stood in a long line of people waiting to pick up absentee ballots, since it's doubtful that they'll be able to vote at their usual polling place tomorrow. After a long wait, when it didn't appear that much progress was being made, she decided to give up and come back later. A group of children playing nearby, while their parents stood in line, were incredulous. "You didn't vote!" they said. "Why are you leaving?"

    There has been a lot of speculation as to how Sandy and the storm's aftermath will tilt the polls, but that is not my concern here. I simply want to remind people of what we so often talk about in regard to kids who struggle—that courage is doing what is difficult for you but easy for others. Please, vote if you can. If you are outside of the Mid-Atlantic and Northeast or unaffected by the storm, vote because you can.

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  • Hurricane Sandy: A Lesson in Community
    Oct. 29, 2012 Harry Kimball

    In the shadow of the extraordinary storm barreling towards the Northeast, New Yorkers have been treated to a distillation of Big Apple behaviors, both stereotypical and oft-overlooked. Yesterday, for instance, I stood in a line outside a Trader Joe's, alongside people young and old waiting to stock up on lentils and tuna fish. A woman walked by and wondered what the line was for. I told her, somewhat sheepishly, and her response was classic. "You guys are crazy! You could go to any other store!"

    But amid all the rampant consumerism—to truly capitalize on the storm, stores have signs announcing that all emergency supply sales are final—and judgmental comments, there is a fellow-feeling in the air that is always here, though it can go unnoticed. I thought it was nicely described by Governor Mario Cuomo in his press conference this morning. "It never ceases to amaze me how New Yorkers are able to rise to the occasion," he said. "We are known for our courage and our toughness, but we also have a sense of community that is really inspirational. And it seems in our darkest hours that New Yorkers shine the brightest."

    Though I don't think Hurricane Sandy represents our darkest hour, the sky is darkening as I write this, and I do see my fellow New Yorkers helping each other out on the streets. And I am sure that our neighbors all across the region, particularly in New Jersey, are doing the same. It's nice to recognize our capability to look out for each other, but I wish for two things. One: that this capability not only be noticed and commented on when we are faced with adversity. And two: that it not only emerge when the challenge to our collective wellbeing is so clear.

    In short, we face little hurricanes everyday, and we look out for each other. We need to celebrate that, too—and do better. "New Yorkers will always make the best of it." a California friend said to me today. Let's prove her right.

    Read more about talking to kids about Sandy and other hurricanes.

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  • Steven Spielberg Talks Bullying and Dyslexia
    Oct. 23, 2012 Rachel Ehmke

    The director Steven Spielberg has recently opened up about his childhood struggles with dyslexia and bullying.

    On 60 Minutes Sunday night Spielberg describes being a "nerd" and an "outsider" growing up, "like the kid that played the clarinet in the band and orchestra, which I did." Spielberg wasn't good at school or at sports, and he was an awkward kid, making him an easy target for bullying. He says he was also bullied for being in the only Jewish family in a very non-Jewish neighborhood. (In the interview his mom reminisces about the evening he snuck out to smear peanut butter on the windows of his tormentors.)

    SpielbergIn another interview Spielberg revealed that he was diagnosed with dyslexia five years ago, which he described as "the last puzzle piece to a great mystery that I've kept to myself." The diagnosis helped explain why he struggled so much in school despite his other obvious talents. Spielberg began making movies as a boy scout at the age of 12 and dropped out of college when he was offered an internship at Universal Studios. "Movies made me feel inside my own skillset, " he told Quinn Bradlee during his interview on Friends of Quinn, a website for young adults with learning differences. Through the years he's discovered how to work with his dyslexia, too. He tells Bradlee:

    I'm in a business right now where reading is very important. It's of critical importance to me that I read books and scripts. And I've been able to overcompensate, and I've basically—never feeling ashamed of myself—will take 2 hours and 45 minutes to 3 hours to read 120 pages. It takes me about two hours and 45 minutes to read what most people can read in about an hour and 10 minutes. I just know that I'm still slow at reading but I've learned to adjust.

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  • Sleep and School: What a Difference an Hour Makes
    Oct. 22, 2012 Caroline Miller

    It's not like we didn't know it, but now we have evidence: Kids who get more sleep behave better in school. Measurably better.

    Researchers in Montreal gave one group of kids ages 7 to 11 an average of 27 more minutes of sleep than they had typically gotten, and found that it cut down significantly on emotional volatility and restless and impulsive behavior at school, according to findings published in Pediatrics.

    On the other hand, cutting about an hour of sleep from a similar group had the opposite effect.

    Okay, there were only 37 kids in the group, and the sleep experiment only lasted for five nights. And if you're wondering about that random-sounding 27 minutes, that's because while they got the children in bed an hour earlier than usual, it seems they only actually slept half that time.

    But still. Their teachers, who didn't know who was pulling extra sleep and who was deprived, recorded significant differences on behavior scales for attention, impulsivity, and emotional lability—crying, outbursts, becoming easily frustrated.

    It's worth noting because it's easy to underestimate how much lack of sleep affects kids' performance in school, and how important it is to address that when you're trying to sort out problem behavior.

    When my kids were in high school, and staying up all hours to study or finish projects they waited too long to start, we used to quote a line we heard another mom use: "Go to bed. Get a B."  Maybe that should be amended: Go to bed. Get an A.

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  • A New Diagnosis for Explosive Children
    Oct. 22, 2012 Caroline Miller

    Chronically irritable and explosive children are the subject of a new disorder called disruptive mood dysregulation disorder, one of the biggest changes in the upcoming psychiatric disorder guide revision known as the DSM-5.

    The disorder—DMDD for short—is the result of a long struggle in the psychiatric community over how to better understand and treat children with uncontrollable behaviors. These kids can be so difficult to manage—to keep them from harming themselves and other children, and even adults—that they are often put on antipsychotic medication or sent to residential treatment.

    Children who are extremely irritable and prone to extreme outbursts have, for the last several decades, been diagnosed with bipolar disorder, though they don't show the classic symptoms, dramatic mood swings between depression and mania. Psychiatrists who work with these kids have been unsatisfied with the diagnostic choices and treatment options they have.

    So the struggle has been to isolate and define this specific set of behaviors in a way that will lay the groundwork for more effective treatment, especially to help avoid overmedication. The Wall Street Journal chronicles the process and thinking that led to the new diagnosis in a very interesting story that lays out the back-and-forth that's gone on in the committee working on this issue, as well as the consequences, in terms of money and medications, that flow from any new diagnosis. Even names of new disorders have consequences, as the uproar against the first name proposed for DMDD—temper dysregulation disorder—demonstrates. Parents hated the name because, as one mother explained, "The use of the term 'temper' in the diagnosis connotes a bad personality," when what the child actually suffers is a "severe condition resulting from a dysfunction in the brain."

    There is always a lot of skepticism greeting new disorders, as if psychiatrists are inventing things for themselves to treat, but as the Journal story makes clear, what everyone agrees is that these children are in severe distress, and there should be a high priority on finding better ways to understand what's happening to them.

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  • 'Falling': A Touching and Sensitive Play About Autism
    Oct. 19, 2012 Michelle Kaplan

    I recently had the privilege of attending Falling, a touching play that just opened off-Broadway at the Minetta Lane Theater in Manhattan. The play explores the challenges and painful issues that families can face when raising a teenage child with autism. Playwright Deanna Jent draws on her own experiences as the mother of an autistic son, and the result is genuine and moving.

    In the play, the parents devote all of their time and energy to managing their 18-year-old autistic son—alternately endearing and angry, mentally limited but physically powerful—and their typically developing younger daughter is left to fend for herself. She carries a lot of resentment towards her parents as well as her brother, and it brings up the issue of how difficult it can be to give equal attention to your children when one child needs so much more support.

    The play brings up the stress that raising a severely autistic child can have on a marriage, when parents have different opinions on how to best deal with rigid routines and aggressive behavior. What happens when one parent feels their child would be safer in a group home? What happens when extended family members don't understand or agree with the decisions that parents make about raising their children?

    In one especially painful moment in the play the mom imagines what life would be like if her son was no longer with them, and her reaction is one of relief. It highlights the emotional double bind a parent can face, being overwhelmed by negative feelings towards a child while also unconditionally loving him. These feelings are not often admitted or accepted without judgment, and Jent is able to portray this in a very honest way.

    Additionally, the play brings up the need for more services to support young adults with special needs who are aging out of the system in our society. I highly recommend Falling, as it is not only an exceptional theatrical experience, but also an educational one.

    Falling has partnered with the Anderson Center for Autism, and producers have announced that through October, $5 from every full-price ticket will be donated to the organization Autism Speaks.

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