The Child Mind BlogBrainstorm
Trying Too Hard to Make Kids Happy
June 15, 2011 Caroline Miller
"If you've got 20 minutes a day to spend with your kid, would you rather make your kid mad at you by arguing over cleaning up his room, or play a game of Boggle together?" It's a question posed by a Harvard child psychologist in an excellent, provocative piece in the Atlantic on whether parents are undermining their children by trying too hard to make them happy. And whether, not incidentally, we do it to make ourselves happy. "We don't set limits," the psychologist concludes, "because we want our kids to like us at every moment, even though it's better for them if sometimes they can't stand us."
The piece, by Lori Gottleib, argues that lavishing too much praise and too few limits on kids can make them them fragile, insecure and noncommittal adults. But the "conflict or Boggle" choice reminds me of what I hear repeatedly from parents of children (lovely, smart, talented children, I might add) with disruptive behavior problems (not-welcome-in-preschool-level problems). The moms tell me they so wanted their time with their kids to be fun, to be nurturing, to be conflict-free, they found it very difficult to exercise authority.
That's where Parent-Child Interaction Therapy comes in, to teach parents how to restructure the relationship so that they're setting clear limits and enforcing them, unemotionally. It's amazing the effect it can have on children, who learn that whining, negotiating, and tantrums won't budge their parents, who are comfortably in charge. As one mom put it, her son has done a 180 in terms of his behavior. "He listens and responds appropriately most of the time. He has gained tremendous control over his behavior and emotions. And at home I have a lot more confidence as a parent, and I see that he responds to it. Whenever I have a weak moment, he might say, 'Mom, is that a direct command?' or 'Mom, should I really be able to do this?' "View Comments | Add Comment
Abuse of Developmentally Disabled in Spotlight
June 14, 2011 Beth Arky
At the last in a series of legislative hearings in Albany on abuse of the developmentally disabled, a New York state official yesterday cited increased reporting of incidents to the police as evidence of recent progress. Courtney Burke, the state's new commissioner of the Office for People With Developmental Disabilities, which oversees the facilities called out in a recent New York Times expose, noted that about 60 percent of allegations are now being reported directly to law enforcement vs. 17 percent before she took office in March.
Burke's figures—which suggest that there are still hundreds of cases of alleged abuse going unreported—show some improvement but fall far short of the kind of substantial reform obviously needed. And these cases are just the tip of the iceberg in a system known for cover-ups and a lack of transparency and oversight.
The hearings were prompted by a series of shocking reports by the Times' Albany Bureau Chief Danny Hakim that have blown the lid off the "culture of abuse" that led to the death of Jonathan Carey, a 13-year-old with autism who was suffocated by a "caregiver" who improperly restrained him in a van in 2007. Hakim notes in today's piece that Burke has proposed a bill to bar the agency from hiring people convicted of violent crimes or sex offenses-though not other convicted felons.
A petition is circulating calling for several laws based on bills drawn up by Michael Carey, Jonathan's father and a tireless advocate for the developmentally disabled.
It calls on state leaders to put basic safety measures in place, including surveillance cameras in facilities and transport vehicles, which might have prevented Jonathan's death. It calls for improved background checks of applicants' records, the lack of which has led to the "recycling" of past abusers from one facility to another, and real protections for whistleblowers. Finally it calls for better supports and services by well-trained caregivers to allow more children and adults with disabilities to live at home with loved ones rather than in residential settings.View Comments | Add Comment
Debunking Myths About Military Families
June 13, 2011 Caroline Miller
Krystel Spell, a mother of two who writes a blog called Army Wife101, has an appealing guest piece on babycenter.com about the stereotypes civilians have about military families. Since the families of the men and women who defend our country deserve not only gratitude from the rest of us but attention to the tremendous stress they are under—emotional and financial—it's worth a look. Misconceptions she addresses include the myth that military families don't pay taxes and that they pop out kids as fast as possible because the government pays them more for each dependent.
For those who think these families are swimming in dough, she notes that starting pay for a private is $1467 a month. "Even during deployments," she adds, "service members only receive $575 extra monthly, which in my opinion is not enough to get shot at."
And she acknowledges the unflattering stereotype that military wive are busy cheating on their husbands while the latter are conveniently deployed in war zones. "The majority of us are loving supportive spouses who are proud of our heroes and who are committed to them and their careers. The last thing most of us would want to do is put the stress of infidelity on them while they’re protecting our country." We might add that if you want to talk about the high divorce rate in military families, you might look at the stress repeat deployments puts on everyone in the family.View Comments | Add Comment
Report Casts Doubt on Effectiveness of Autism Screening and Early Intervention
June 13, 2011 Harry Kimball
A review of the research on screening and early intervention for autism in young children has produced an unorthodox conclusion: don't do either. The article appears in Pediatrics, the journal of the American Academy of Pediatrics, which does not seem particularly keen on the association. (Opinions "are those of the authors and not necessarily those of the AAP," a spokeswoman tells Miriam Falco, who wrote up the brouhaha for CNN.) To tell the truth, Falco doesn't seem particularly impartial, either. "The report's authors are cerebral palsy experts at McMaster University in Ontario," she writes, while experts who actually "diagnose, treat, and study children with autism"—my emphasis—"said they were puzzled and concerned by the new report's conclusions." Is this a case of specialists wandering too far outside their comfort zone?
The AAP suggests screening at 18 and 24 months, meaning that pediatricians go through a simple checklist to determine whether children are developing typically or could be showing signs of a developmental disorder. But "good screening tools and efficacious treatment is lacking," the report states. Autism is a real problem, the authors admit; they just want to "find the children who truly have autism and find ways to help them" that aren't our current interventions, which do "not significantly improve the cognitive outcomes of children."
Experts south of the border aren't buying it. They point out that any screening tests are often used in conjunction with a doctor's periodic observation of a child for signs and symptoms. And early intervention is effective and proven so, they tell Falco; the Canadian researchers just didn't consider the studies with positive results. This isn't just an academic issue: there is real worry it could unintentionally sabotage families' access to care if insurance companies can point to a paper in a journal that says the interventions don't work.
"I would hope our debate would lead to an action," one of the authors tells Falco. Let's hope that action is to better educate both the medical establishment and the public about the proven preventative measures and interventions for autism while at the same time striving to make them better—not throwing the proverbial baby out with the bathwater.View Comments | Add Comment
Do Girls Have a Natural 'Immunity' to Autism? Could Be
June 10, 2011 Harry Kimball
Drawing from the same sample population as Child Mind Institute Scientific Research Council member Matthew State (see here), geneticist Michael Wigler has completed a parallel study and made some pretty bold statements about the causes of autism, the gender disparities in diagnosis, and possible related disorders. Wigler and his team undertook an analysis of the 1000 families of the Simons Simplex Collection with an eye towards bolstering what he calls his "unified theory of autism," a theory that hasn't found overwhelming favor in the wider community.
What is this shocking theory? Wigler has proposed that while autism is, indeed, heritable—passed from parents to children—the great majority of cases of the developmental disorder arise from "de novo," or spontaneous, genetic mutations in the reproductive cells of the parents. Seems unlikely? Stay tuned.
By studying the genome of the parents, siblings, and the affected child in the Simons Simplex Collection, Wigler has concluded that there are perhaps 300 or more specific places in the genome that, if a mutation occurs, leads to autism. Hence, all that is needed to account for a majority of the cases we see is for a mutation to hit a relatively large target.
Since mutations occur with equal frequency across gender, Wigler needs to explain why four times as many boys are diagnosed with autism as girls. Here is Wigler's big leap: He concludes that there are many girls with the same mutations as their male counterparts who are not symptomatic. Among those girls who are diagnosed, he notes, the damage done by mutation was much more extensive than the boys.
So that means that women are "resistant" to symptomatology, but can also be carriers, passing on the mutations to their children through simple hereditary transfer.
These carrier girls "may encounter difficulties at later stages of their lives that manifest as a different diagnostic category," he told ScienceDaily. It's "most likely to be one with a gender bias opposite that of ASD" like anorexia, he said. This seems to be idle speculation. But backing up a theory of autism with good data, a theory that could lead to prevention and new treatments, is alright in my book. The study is in Neuron.View Comments | Add Comment
Study: Mental Health Is Top Concern for Youth
June 9, 2011 Web MD
A sturdy, healthy, and carefree childhood is increasingly a myth: a report from the World Health Organization (WHO) identifies the three main causes of disability in individuals ages 10 through 24 worldwide to be neuropsychiatric disorders, unintentional injuries, and infectious and parasitic diseases. Researches used disability adjusted life-years (DALYS) to compute their results, which estimate how many years of life are lost due to both premature deaths and disabilities related to these specific causes. They found that, for the age range, neuropsychiatric disorders contribute to 45% of years lost due to disability; unintentional injuries contributed 12%, infectious and parasitic diseases 10%. The report comes as no surprise to mental health experts. "Increasingly, we are starting to realize the onset of about half of all lifetime cases of mental illness begin by age 14," says Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI). The report spells out a need to target new prevention strategies at teens and young adults.View Comments | Add Comment
Brain Calisthenics for Abstract Ideas
June 8, 2011 New York Times
What is the value of intuition and gut instinct in education? Can a child with an eye for fashion or wordplay apply this to her formal education? A new study explores an approach to learning that can deepen a person's grasp of principles and knowledge. "Perceptual learning" is a form of education that relies on a bottom-up ability of pattern-recognition. Rather than the traditional "top-down" instruction that teaches rules and then assigns problems, perceptual learning hones instinct and the ability to quickly grasp the type of problem one is facing. This can be valuable for creative problem-solving, as well as real-life situations that require resilience and intuition. Scientists and teachers are still pondering the implications this new concept could have for children's educations.View Comments | Add Comment
Hoarding, hand-washing and obsessive checking: Which of these is not like the others?
June 7, 2011 Los Angeles Times
Are obsessive-compulsive disorder behaviors genetic? Are they even manifestations of the same disorder? A recent study explored the question of nature and nurture in various obsessive-compulsive disorder symptoms like hand-washing, rituals, checking, and hoarding behavior to determine whether or not they share the same origin. If not, perhaps they need to be treated differently. Using the UK twin registry, researchers found that the genetic origin of OCD was strongest with hand-washing, whereas hoarding behavior appears to have a different origin or environmental cue, and may actually qualify as its own separate disorder.
Know More: OCD: It's Like a Bully in Your BrainView Comments | Add Comment
Adapting a Show for Children With Autism
June 7, 2011 New York Times
Shows adapted for children with autism are few and far between, but Paper Mill Playhouse recently brought tears to a mother's eyes with their new commitment to special "sensory-friendly" shows. "Stone Soup and Other Stories," a children's show to be presented on June 11, is adapted to be more literal, more lighted, and less loud, with other activities designed to make children comfortable during the performance. Executive director of Autism New Jersey, Linda Meyer, said, "For those parents, having Paper Mill listen to them and respond was just such a gift, because this is going to be an opportunity for them to come out and enjoy something with their entire families."View Comments | Add Comment