The Child Mind BlogBrainstorm
Adam Jeffrey Katz Memorial Lecture
May 17, 2012 Child Mind Institute
Yesterday was the 10th Annual Adam Jeffrey Katz Memorial Lecture at Hunter College's Kaye Playhouse in New York City. The two-part program, designed to raise awareness and educate the public about ADHD and dyslexia, was attended by over 500 people.
Part one featured Dr. Stephen Hinshaw, co-chair of the Scientific Research Council and an expert on attention-deficit hyperactivity disorder. Dr. Hinshaw's talk on ADHD covered everything from causes, public health policy, and the persistent stigma associated with the disorder to treatment possibilities and the effectiveness of stimulant medication.
The lecture was followed by a question and answer session with Dr. Harold Koplewicz, president of the Child Mind Institute, and Academy Award-winning producer Brian Grazer. Mr. Grazer spoke about the challenges of growing up with dyslexia. He attributed his successes to being resourceful and pushing himself harder in other aspects of his life. Ultimately, his message was one of resiliency and the importance of championing the successes of children with learning disorders.
In his conversation with Dr. Koplewicz, Mr. Grazer described how his grandmother's belief in him set up conditions for his success in everything from reading to swimming to moviemaking, sounding much like a child treated at the Child Mind Institute might. "As much as all of the forces of reality, meaning empirical evidence, were showing that I wasn't, she was able to overpower me and make me believe that I was special," he said. "So any time I could have a success that was a unique success, I felt like Superman."
View photos from the event:
Read live-tweets from the event:
The lecture began in 2002 in memory of Adam Katz, who struggled with ADHD and dyslexia. The Katz family created this living memorial to raise awareness about psychiatric and learning disorders. This event is made possible by the generosity of Ellen and Howard Katz.Read More
Psychopathy and Nine-Year-Olds
May 15, 2012 Rachel Ehmke
The most emailed article on the New York Times website right now is a story published in the magazine this weekend called "Can You Call a 9-Year-Old a Psychopath?" The title is alarming, as are the real stories related in the piece, and you can see why so many people are riveted by it. In an odd coincidence, This American Life also reaired its psychopathy episode this weekend, making the subject unusually popular (if you don't count nights when Dexter is on TV.)
The blunt answer to the question posed by the Times is no, you can't call a nine-year-old psychopathic since the DSM explicitly rejects anyone under 18. This is because psychiatrists and psychologists believe that children's minds are still malleable and continue to be shaped by a combination of biological and environmental factors even until young adulthood. As it is understood now, psychopathy—also called sociopathy but properly known as antisocial personality disorder in the DSM—is a label that can't be applied to a brain that is still developing. And while we all have some sociopathic characteristics, such as a tendency to lie and manipulate, or be impulsive and narcissistic, children can struggle in particular with these traits during their maturation, especially if they also have some other psychiatric disorder. According to a study by Lee Robins mentioned in the Times, almost 50 percent of the kids who scored high on antisocial qualities did not become psychopathic in their adulthood.
That doesn't mean that some kids don't seem to make a good case for it. The Times story centers on Michael, a boy who scored nearly two standard deviation points outside the normal range for callous-unemotional behavior. Michael is manipulative and alarmingly canny for a nine-year-old. He also seems to lack empathy. His behavior is extreme and certainly indicates a problem, but whether that problem is budding psychopathy is still unclear. His parents have received a laundry list of diagnoses for him over the years, although none seemed to fit exactly.
The tangled and complicated nature of psychiatric symptoms often makes getting a good diagnosis difficult. According to Dr. Alan Ravitz, a Child Mind Institute psychiatrist, what often appears to be antisocial and insensitive behavior is actually a manifestation of another psychiatric disorder. Dr. Ravitz says he has treated patients who seem to be sociopathic, but after treating their underlying disorder (depression, paranoia, oppositional defiant disorder, ADHD) the apparent sociopathy is gone. When I spoke to Dr. Ravitz he emphasized the importance of recognizing true antisocial personality disorder and applying the best resources available to treating it, but he noted, "I think we should be slow to diagnose sociopathy because it can sometimes be a stand-in for past failures in treatment. It can distract us from the real psychiatric disorder for which we already have effective treatment."
Of course, the other piece to this story is how badly we need more research on antisocial personality disorder. Some work has already been done, but not enough. This is partially because psychopathy is incredibly rare, but it's also because it often leads to criminality. As a psychologist told the Times, "No one is sympathetic to the mother of a psychopath."
But thoughtful media coverage is the enemy of stigma, and this article has inspired many supportive comments on the Times website. Hopefully the story will help humanize an often inhuman-seeming disorder. So many psychiatric disorders in children have proved responsive to early intervention that we can't stop pushing for some way to help these children and their desperate families.Read More
The TIME Breastfeeding Cover Brouhaha
May 14, 2012 Caroline Miller
It was quite the Mother's Day cover, a hot-looking young mom posing with a kid in camo pants nonchalantly standing on a chair, attached to his mother's breast. It didn't even need the provocative headline—"Are you mom enough?"—to cause a sensation (and of course be knocked off all over the web, with stand-ins for the mom from John Boehner to Steven Tyler). It's as if TIME magazine wanted to simultaneously offend those who might find the image tasteless and those who might find the parent-baiting offensive. A double whammy.
The story itself revisited the pros and cons of what's called "attachment parenting," the extreme child-rearing philosophy that has been around for 20 years and has gradually worked its way, at least in watered-down form, into the mainstream. The three key tenets, writes TIME's Kate Pickert, "are breast-feeding (sometimes into toddlerhood), co-sleeping (inviting babies into the parental bed or pulling a bassinet alongside it) and 'baby wearing,' in which infants are literally attached to their mothers via slings." The theory is that the more time children spend in physical contact with their mothers in the first few years the more secure and happy they will be later.
As the story notes, this theory has been knocked about a great deal over the years, and there is no evidence whatsoever to back the notion that this literal closeness has any advantages for a child's development over other forms of parental love and attention. It's interesting to visit Dr. William Sears, now 72, who, with his wife Martha, hatched the philosophy, along with seven children of their own.
Seems harmless enough, except for the obsessiveness with which it's being wielded in this era of perfection parenting—no effort is too great to create the ultimate child. If it's possible to be self-sacrificing and narcissistic at the same time, this would be one way to do it.
Above all the story illustrates the downside of competitive parenting, with manifestos like this being used to achieve superiority over other families in which women don't choose, and/or can't afford, to be stay-at-home moms.
As Donna Wick writes on the Freedom Institute's blog, it's important to resist letting passion for your children be manipulated into a judgmental stance about other parents. It's one of the things that makes parenting in the 21st century harder than it needs to be, whether or not you buy into attachment.Read More
Managing Behavior: Tips for Parents and Teachers
May 11, 2012 Child Mind Institute
Our second facebook event was a presentation by Dr. Melanie Fernandez where she presented tips and strategies for parents and teachers on managing difficult behvaior.
If you missed our live facebook talk, you can view it here:
Or download the slides here.Read More
Kids With Differences Face Outsized Challenges
May 10, 2012 Lyn Pollard
Last night I had the honor of attending a Speak Up for Kids talk, one of many that are taking place across the country in honor of Children's Mental Health Awareness week. As a volunteer (and the parent of two kids with differences), I've been working with the Child Mind Institute and the Dallas Academy to both plan the event and to draw parents in my local community to it.
While the topic "A Parent's Guide to Bullying" drew parents and educators to the event, once we entered the Q&A session, the discussion quickly turned to our children with differences, who are often targeted by bullies. I was blown away by the honesty and reality of our discussion, and was reminded that I am not alone in this fight to provide my two children with an appropriate education in a safe learning environment.
Parent after parent talked about how their child has been victimized, not just in the form of bullying, but by being denied appropriate accommodations and special education services on their child's public school campus.
Dr. Jen Crawley at the Dallas Academy.
One parent, a single mom and active military member, spoke through tears about how her extremely bright 7-year-old son is being "singled out" daily by his teacher due to his severe ADHD. He also has problems socializing, describes himself as "weird" and has been repeatedly bullied. Yet, after multiple meetings with both her campus and district administrators, she had not been provided with information about her child's rights under 504 or been informed about the possibility of an IDEA (special education) assessment to determine if her child is eligible for special services.
Another parent, a former special education teacher, shared about how her 14-year-old son has been denied protection under IDEA. Despite having provided the school district with three separate doctor's reports stating that her son has Asperger's syndrome, her son's IDEA assessment showed that he "did not meet the eligibility criteria" for services. Also through tears this mom went on to describe how her son, a constant victim of bullying, ultimately "became the bully" when he began displaying aggressive behavior. "What do I do?" she pleaded to our group, explaining that she has already pulled him out and had begun home-schooling.
According to the National Center for Learning Disabilities, kids with differences and special needs have a greater than 60% chance of being bullied. But, the statistic we don't hear is the one quantifying how many children in this country are not receiving the services they need for learning differences and special needs in our nation's schools, despite having both federal and state laws in place to protect them.
I am hopeful that the Speak Up for Kids events will spark a larger conversation across our country about protecting our kids with differences. However, it's going to take a lot more than talk to motivate our nation's leaders to address the concerns of parents who are begging for appropriate accommodations, services and protection for children who draw outside the lines, and are too often overlooked and underserved in our nation's schools.
Perhaps the question is, when we speak up for kids, who is listening?
Lyn Pollard, a mother and advocate, blogs at Different Doodles, among other outlets.Read More
Parenting in the Digital Age Tweetchat
May 9, 2012 Child Mind Institute
Yesterday, Dr. Ron Steingard was joined by Caroline Knorr, Parenting Editor of Common Sense Media for a tweet chat in honor of National Children's Mental Health Awareness Week. If you missed it, a partial transcript is below.
Also join us for: A live Facebook talk on Friday, May 11th with Dr. Melanie Fernandez presenting "The Difficult Child: Managing Behavior."Read More
Dr. Bubrick Speaks Up for Anxious Kids
May 8, 2012 Harry Kimball
Yesterday, as part of Speak Up for Kids, Dr. Jerry Bubrick gave a talk at the 92nd St. Y in New York, just as hundreds of other mental health professionals are doing nationwide. Dr. Bubrick, director of the Child Mind Institute's Anxiety and Mood Disorders Center, focused on the dos and don'ts of childhood anxiety disorders—how do we know when to intervene? And what's the best way to help a child who is in distress?
Anxiety in children, whatever the cause or specific disorder, is a problem when it impairs a child's ability to do everyday things, when it is pervasive and out of proportion, when it is difficult for a child to recover from, and particularly when it leads to avoidance. Avoidance can be defined roughly as dramatic changes in habit or routine for the express purpose of skirting anxiety-provoking situations. While we want to temper the impairing effects of an anxiety disorder, Dr. Bubrick told the attendees, anxiety itself is not really the enemy.
"Anxiety is actually a good thing," Dr. Bubrick said. "It is protective and adaptive, and it helps us be successful. We don't ever want to 'cure' anxiety—we want to manage it." For parents, teachers, and professionals, that means first thinking about their own responses, and their desire to keep kids from suffering. A parent who shields a child from anxious situations—who enables avoidance—is perfectly understandable, said Dr. Bubrick. "There are good intentions there, but the whole idea of not allowing our kids to feel anxiety actually hurts them more than it helps them."
Instead, continued Dr. Bubrick, adults need to encourage the development of more functional coping skills. "We don't want to eliminate the stress; we want to figure out ways to help kids cope with it. We want to reward them for trying to those things they are anxious about, rather than trying to pull them away from them." One way of encouraging this "engagement" with their anxiety is setting up a reward system that brings kids more frequently into distressing situations with continual support.
"Jump into the water on a cold day, and you feel cold for awhile before you adjust," Dr. Bubrick said. "The same thing happens with anxiety. If we allow our kids to experience anxiety without pushing it away, without trying to avoid it, they actually learn how to adapt to it and overcome it."
The audience included concerned parents, mental health professionals, and educators who all had questions for Dr. Bubrick covering a wide variety of subjects. Fretta Reitzes, director, of the 92nd Street Y Goldman Center for Youth & Family, said that the collaboration between professionals and parents and teachers is representative of the Y's mission and demonstrates why the Y and the Child Mind Institute are a "good fit." She is happy that we can all work together to "spread the word."
You can help too! Please join us at our online events this week, and at another 92 Y talk this Thursday evening at 7:30. Dr. Steven Dickstein will address raising children in the digital age in "Parenting 2.0."Read More
Maurice Sendak Sails Away at 83
May 8, 2012 Harry Kimball
When we heard that Maurice Sendak died today, at 83, my first thought was of all those teenagers obsessed with The Hunger Games and the rest of the current crop of post-apocalyptic young adult fiction. Not because Sendak wrote young-adult fiction—he'd have been appalled at that thought—but because for so many of those kids, Sendak's weird and wooly Wild Things were their first taste of the fictional dark side. Sendak was stunningly and unapologetically tuned into children's desire, and, indeed need, to acknowledge the feelings that make their world more fraught than we'd like to remember. And still, Where the Wild Things Are appears immortal. Few books I know of so consistently span generations in their appeal.
Where does that appeal come from? "There's a cruelty to childhood, there's an anger," Sendak told the AP in 2009. "And I did not want to reduce Max to the trite image of the good little boy that you find in too many books."
In an interview with Stephen Colbert that aired earlier this year, Sendak managed to further elucidate his philosophy between a surprising number of one-liners and dyspeptic glee. (I heartily suggest watching it, though a predilection for Colbert's style of satire is probably a prerequisite.) In response to a leading comment from the comedian on the "simple" task of being a child, Sendak says: "There is something in this country that is so opposed to understanding the complexity of children. It's quite amazing." We have to agree. In his weird and wonderful way, Sendak never stopped speaking up for kids.
Margalit Fox, in the New York Times obituary for Sendak, writes that he portrayed "a luminous world, at once lovely and dreadful, suspended between wakefulness and dreaming. In so doing, he was able to convey both the propulsive abandon and the pervasive melancholy of children's interior lives." This doesn't mean that he encouraged sadness or carelessness. But he plumbed the depths of the childhood psyche and found a mirror to reflect it. His books have this message for children: "I understand."Read More
Speak Up for Kids Live
May 7, 2012 Child Mind Institute
We kicked off National Mental Health Awareness Week today with a live Speak Up for Kids webinar on our Facebook page. More than 300 people around the globe tuned in to Dr. Kurtz's talk, "Is It ADHD or Just Inattention?"
If you missed it, you can watch it below.
Or click here to download the slides from the talk.
Also join us for:
- A live tweetchat on Tuesday, May 8th with Common Sense Media and our expert, Dr. Ron Steingard on "Parenting 2.0: Parenting in the Digital Age."
- A live Facebook talk will also take place on Friday, May 11th with Dr. Melanie Fernandez. She will present "The Difficult Child: Managing Behavior."
Visit us on Facebook at http://www.facebook.com/ChildMindInstitute and watch the talk live on the day of the event.Read More
Junior Seau and the Future of Football
May 4, 2012 Rachel Ehmke
In some ways, the worst thing about Junior Seau's suicide earlier this week was put into words by former Giants linebacker Harry Carson: "When I heard it, I have to say in the past I would have been shocked. But I'm not shocked anymore."
Seau was a beloved player, known for his passion and for being on the 1994 San Diego Chargers team that won the AFC championship. Along with mourning there is obvious speculation that Seau may be yet another casualty of chronic traumatic encephalopathy (CTE), a neurodegenerative disease linked to concussions and characterized by dementia and depression.
Seau's suicide was chillingly reminiscent of fellow former NFL player Dave Duerson who, like Seau, shot himself in the chest. Duerson also left a note requesting that his brain be given to the NFL's brain bank for evaluation, and researchers later confirmed that Duerson was indeed suffering from CTE. Seau's family has agreed to have his brain studied, too.
But the list of professional football players who have committed suicide is increasingly horrifying; Carson, who says he still suffers the effects of concussions he sustained during his career, cited Andre Waters and Ray Easterling, who killed himself on April 19.
We may find that Seau was suffering from CTE at the time of his death, or we may find that he wasn't. His suicide is a tragedy either way. And the connection between the disease and football is well established, and shouldn't be ignored. We are able to help people suffering from depression, but we can't undo the brain damage once it has happened. This is why it's important for us to focus on the children in upcoming generations who will be playing football: let's make sure they inherit the sport but not the disease.
For a great memorial of Junior Seau, check out Deadspin's story "The Night Junior Seau Picked Up A Marine Captain's Tab And Serenaded Bar Patrons With A Ukulele".Read More
For more about concussions, read What Parents Should Know About Concussions.