Archive for the ‘ Questions ’ Category

Should Sharing – Or Not Sharing – Be Mandated In Preschool?

Wednesday, April 24th, 2013

Should young kids be told that they must always share? Should they be told that they never have to share? Or should they be encouraged to learn how to try to work things out themselves? 

The answer from decades of research on preschoolers is … they should get experience in trying to try to work things out themselves, with good guidance from adults.

To get an expert perspective on this, I contacted Dr. Melanie Killen, who is Professor of Human Development, Professor of Psychology (Affiliate), and the Associate Director for the Center for Children, Relationships, and Culture at the University of Maryland.  She is the author of Children and Social Exclusion: Morality, Prejudice and Group Identity (2011), co-editor of Social Development in Childhood and Adolescence: A Contemporary Reader (2011), and serves as the Editor of the Handbook on Moral Development (2006, 2013). Dr. Killen has a distinguished record of conducting seminal research on the social, moral, and cognitive development of preschoolers (as well as older children), and as such is well positioned to offer a perspective on sharing in the preschool years. Below is her take on a few key issues.

ARE EXPERIENCES THAT ARISE FROM CONFLICTS ABOUT SHARING IMPORTANT IN EARLY CHILDHOOD?

Yes. Sharing toys and resources is a fundamental aspect of early childhood social interactions that promotes the development of social competence. In fact, children who learn how to resolve conflicts about sharing in constructive ways (e.g., through negotiation and bargaining) are more liked by their peers and better adjusted in school contexts than are children who resort to aggressive strategies (such as insistence on one’s own way). What children learn from conflicts about sharing toys under optimal conditions is how to bargain, negotiate, and apply principles of fairness to their peers.

WHAT’S WRONG WITH TELLING KIDS THAT THEY HAVE TO – OR DON’T HAVE TO – SHARE?

A policy that mandates either sharing or “no sharing” is a problem from the start because it removes the opportunity for children to understand the principles that underlie sharing behavior.  These principles include the fair distribution of resources – how do we share resources (or toys) in such a way as to treat others with mutual respect?  This involves explaining to children the conditions in which not sharing toys is being unfair to another child (“If you play with all of the toys then he won’t have any to play with”). However, it’s also important to recognize that there are also conditions in which not sharing toys is viewed as legitimate, such as claims to ownership (“This is her special birthday present and she doesn’t want it to get broken”), or previously agreed upon rules about the use of resources (“She had the toy yesterday so today it’s your turn to use the toy”).

WHAT ROLE SHOULD ADULTS PLAY IN SHARING?

The bottom line is that a unilateral policy takes away from the learning opportunities for young children through which they teach each other what makes it wrong to refrain from sharing (“You had it all morning and I didn’t get to play with it so can I play with it now?”).  Adults need to facilitate the opportunities for children to discuss, negotiate, and interact about how to play with toys, especially in early childhood when the stakes are still low.  Learning how to share toys, which includes the recognition of ownership claims is a fundamental social skill that is related to constructing notions of equality, fair treatment, and mutual respect.

Children Playing via Shutterstock.com

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Can a Child “Outgrow” Autism?

Thursday, April 18th, 2013

Autism DiagnosisAs April is Autism Awareness MonthI am taking on some of the most frequently asked questions about Autism Spectrum Disorder (ASD). “Can A Child ‘Outgrow’ Autism?” is one of the basic ones. A new study released earlier this year suggests that the answer is … yes.

To get to this answer, the study took on two core issues that need to be resolved:

  • Did the youth really have ASD? (Or put another way –  were they misdiagnosed initially?)
  • Did the youth fully recover? (Or put another way – did they lose all of their symptoms, or just enough to lose the diagnosis?)

This study was able to address these issues by combining the clinical resources of a number of institutions, and by using a longitudinal design that tracked kids over time. Via comparisons with two other groups of kids (one with current ASD, another without ASD) - along with rich clinical and developmental histories –  they were able to document complete recovery in 34 cases. By complete recovery, they answered the above questions as follows:

  • The youth had documented ASD earlier in life using current diagnostic criteria.
  • The youth lost all of their symptoms over time (not just some of them).

The question the study has not answered yet is what factors contributed to the complete recovery of these 34 cases. It is anticipated that a future publication will examine this.

While complete recovery is a goal for many parents, right now it is not the typical outcome for the majority of kids with ASD. That said, great strides are being made with intervention – especially early intervention. Getting kids diagnosed early and using that as a platform for early intervention will always lead to improvement in functioning over time, even if complete recovery is not achieved.

Autism Diagnosis via woaiss / Shutterstock.com

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Boston Marathon Explosions: Be In Control of What Your Child Will Hear and See

Monday, April 15th, 2013

Mother Soothing Young ChildThe news of the explosions at the Boston Marathon once again necessitates that parents take control of what their kids will hear and see. Here are a few key points to keep in mind.

Be aware that coverage (TV and online) of these explosions – and the coverage will be continuous and extensive – will have some graphic footage. There are recordings of when the explosions happened. There are images of injured people on stretchers. You will see the aftermath which can be disturbing.  It will be on TV. It will be online. Keep this in mind in terms of what your kids will see. Kids of any age will find this disturbing. It’s a good idea to monitor your kids now so you can be in control of what they see – and be on the ready to switch off quickly if there are things they shouldn’t see.

In addition to footage, remember that interviews will contain graphic talk. People will be describing what they saw and heard. Many will be distressed. The talk may be graphic and reference fatalities. Online, you will read quotes by witnesses. Again, you might want to actively screen this information.

While shielding your kids from footage and conversation that is upsetting, it’s also important that you be the source of information for them. You can explain things in the best way possible without deviating from being honest. Keep your descriptions short and factual (“Yes something bad happened. Some people were hurt.”) without going into much expansion. Allow your kids to ask you questions and answer exactly what they are asking. For example, if they ask if anyone died, you can simply answer “Yes” and see if they ask anything else. Try to be calm and in control even though these catastrophes rattle all of us. Even though we can’t assure our kids that we can keep them safe every second of the day, we do want them to feel safe with us and have some sense of control.

Finally, be aware that your kids may have questions for awhile, as this tragedy will undoubtedly be in the news for some time. Keep the lines of communication open and be ready to have frequent and short conversations about it – kids may have a question here or there and they are only looking for an immediate answer to it. You can rely on your knowledge about your kid’s personality, but do bear in mind that kids typically don’t want the level of detail that we adults would pursue.

And of course do what you do best – hug your kids. That will speak volumes.

Discussing Tragedies

Mom Soothing Child via Shutterstock.com

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Is TV Viewing The Unhealthiest Screen Time For Kids?

Tuesday, April 9th, 2013

A new study published in Pediatrics suggests that it may be, at least when it comes to risk for obesity. 

WHAT DID THE STUDY DO?

91 teens (45 girls) around 14 years of age responded multiple times a day – via an electronic diary – to questions about what they were doing, over a 1-week period. Included were questions about a variety of screen time activities (for example, TV, video games, computer) and how much attention they were paying to each activity. Electronic diaries are an excellent method for getting kids to report on what they are doing in “real time” – it’s quick and easy for them to do and studies have shown that they provide reliable data using this method. The kids also had their height and weight measured by the research team in order to calculate their body mass index (BMI) – which is one metric used to measure risk for obesity.

WHAT DID THE STUDY FIND?

The overall findings were intriguing. First, the raw amount of screen time reported by the kids was not associated with their BMI. The statistical association of interest involved TV, but again it wasn’t about how much TV the kids were watching. Rather, it was how engaged the kids were when watching TV that was associated with BMI – the more a kid reported that they were paying the MOST attention to TV (versus all other activities), the higher their BMI.

WHAT DOES THE STUDY MEAN?

There are limitations to the study design that need to be addressed. The most prominent is that each teen was only observed during the 1-week period (this was a “cross-sectional” study).  Finding statistical associations in a cross-sectional design limits what we conclude because we can’t tease apart what leads to what.  It could be that kids with the highest BMI levels were the most likely to become engaged in TV viewing. It could be that TV viewing was one of the causative factors for their increased BMI levels. The point is that with these kinds of data we can’t distinguish between those interpretations. And of course we don’t have data on younger kids from this study, so technically there are no inferences to be made on non-teens.

WHAT SPECULATIONS CAME OUT OF THE STUDY?

Noting the limitation discussed above, researchers use cross-sectional data to generate and support hypotheses to be tested in future studies. The interesting idea that comes out of this paper is the speculation on the specific health risks associated with TV viewing versus other forms of screen time. One deserves particular mention. They note the potential impact of commercials promoting unhealthy foods – which may be particularly influential for kids who are highly engaged watchers. What’s interesting here is the idea that it’s not just about screen time, and it’s not just about TV – it’s about the specific risk of being a highly engaged TV viewer that seems to be linked with BMI. But future work will need to measure all these things and evaluate them longitudinally.

WHAT’S THE TAKE-HOME MESSAGE HERE?

Clearly this paper is the beginning, and not the end, of the story. The story, however, may be quite informative for parents if future studies replicate and expand the finding – and particularly if longitudinal studies provide clearer evidence of the directionality of the findings and support for the hypothesized mechanisms. Starting with younger samples of kids and tracking them across time will help determine if engaged TV viewing is especially linked with increases in BMI. But right now the interesting idea for parents to think about – at all ages – the potential downside of when kids get too attached to passive activities. This study suggests that TV may be the worst culprit for multiple reasons. But the bigger picture is that we are probably moving away from talking about screen time per se – many kids are increasing rather than decreasing screen time – and shifting toward a focus on unhealthy habits and unhealthy content that may be linked with specific types of screen time.

So … right now keep on eye on when your kid seems most likely to pair eating with screen time, and see if you can discourage that link. And see for yourself at home if it seems to happen more when they are especially glued to the tube.

Remote Control and Salty Snack via Shutterstock.com

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Is ADHD On The Rise – Or Just Overdiagnosed?

Monday, April 1st, 2013

The latest numbers on the rate of ADHD are extraordinary. The New York Times has reported data collected from the Centers for Disease Control and Prevention which suggest that 11% of youth (between 4 and 17 years of age) have been diagnosed with ADHD at some point in their lifetime. 

This is troubling – primarily because the data come from phone surveys of parents. This means that parents are receiving this diagnosis at unprecedented rates – not that kids are being properly diagnosed with ADHD at higher rates than before. It is too easy for kids to get labeled ADHD and not go through the comprehensive screening that should take place as administered by a multidisciplinary team of professionals.

It’s becoming clear that ADHD is being used as a label to try to provide a quick handle on behavior that may – or even may not – be somewhat troublesome. ADHD involves much more than not sitting still and not paying attention. All kids exhibit “ADHD” like behaviors now and then. It’s a difficult condition to diagnose because it is based on increased frequencies of a number of behaviors across a number of contexts (home and school) for a sustained period of time which cause impairment for the child. Without a detailed diagnostic process, it can be too easy to misread normative behaviors as symptoms of ADHD.

Part of the increase comes from diagnoses of older kids including those in high school. Diagnostic criteria are beginning to reflect the thinking that symptoms can develop later in childhood and even in the teen years (and not just the early years). That said, it can also become another convenient label for a kid who is not doing well in school. At the other end of the spectrum, diagnosing preschoolers can raise related issues in terms of figuring out which kids are really showing early signs and which kids are just being kids.

There are a number of problems with overdiagnosis. Kids typically get treated with drugs that are not appropriate for them. They get labeled rather than receive the kind of attention that they deserve (for example, to improve their engagement in the classroom). And some kids get diagnosed simply because they are in very large classrooms which promote inattention and not sitting still.

The less obvious issue is that the cursory diagnosing that may be going on is also a disservice to kids who do suffer from ADHD. They should be getting full assessments and comprehensive treatment plans that find optimal combinations of psychosocial intervention and, when necessary, well monitored use of drug therapy. Tossing around labels and drugs as a diagnostic and treatment strategy is not going to give them the help they need, especially since we know that ADHD can persist into adulthood and cause much in the way of academic and social impairment.

The bottom line? If you are a parent, and you (or someone else) suspects that your child might have ADHD, try to seek out an assessment from a multidisciplinary team that has the requisite experience to know how to sort out normative behaviors and issues from clinically meaningful ADHD. You might need to network with other parents, your pediatrician, and educators to locate a provider. But it will be worth your time and effort to make sure your child isn’t misdiagnosed as having ADHD – or not given the proper assessment and treatment plan if they do show the clinically meaningful symptoms of ADHD.

ADHD image via Shutterstock.com

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