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Monday, September 16th, 2013
The moment arrives. The baby’s here. Your life as mom or dad begins. And it’s not too early to marvel at how your newborn is wired to interact with you.
One of the classic ways to realize that your newborn is tuned into what you do is to stick your tongue out. In the first few days of life, many babies will stick their tongue out too.
WHAT’S GOING ON? Researchers have explored this phenomenon for decades, and some have continued to question if this is really social imitation (scientists are very good at coming up with – and ruling out – all kinds of alternative explanations for behaviors we observe). But a recent study of newborns has looked at this phenomenon of “imitation of tongue protrusion” and has concluded that it is what it is – even in the first few days of life babies are fascinated with your face, what it does, and in some cases have the neuromuscular control to copy you as a way of connecting with you.
WHAT DOES IT LOOK LIKE? Check out this 10-minute old newborn demonstrate “imitation of tongue protrusion.”
SHOULD I WORRY IF MY BABY DOESN’T DO IT? Keep in mind that “imitation of tongue protrusion” is not a diagnostic test. Some babies do it, some don’t. It’s not something to “work at” to make sure they do it. That’s not the point at all. The point is that your newborn is waiting to interact with you. There are many ways to nurture that fundamental urge, like gently stroking their cheek to promote them to turn their head, also known as the rooting reflex (which is a handy way to learn how to direct the head and mouth to a food source). Check out this list of 50 simple things you can do to “make your babies smarter” that are interactive, playful, and stimulating.
IS THIS JUST ABOUT LEARNING? All of these ways of interacting with babies promote brain development and provide the type of optimal stimulation they need. It’s good to know that babies are equipped with the ability to search out exactly what that is – something researchers call the “Goldilocks effect” – as they can, for example, scan for just the right amount of information they need in the human face at different ages. But beyond the purely cognitive elements here, remember that it’s really about the social bonding. Your baby is not only learning that the world is interesting and full of surprise and stimulation, he or she is discovering the joy of having you there to bond with, play with, and love.
Newborn Sticking Out Tongue via Shutterstock.com
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Tuesday, July 30th, 2013
Kids have heroes. They always have, and they always will. Adults have them too.
But what do we tell our kids when our heroes fall?
The world of sports offers lots of opportunities to see personal success and failure. When the success happens, it reinforces why athletes are heroes to our kids. When they fail though, it’s not clear what it means to them.
Baseball, for example, has been plagued for years now with issues related to Performance Enhancing Drugs. While the “steroid era” has seemingly passed us by (one in which a good number of players with Hall of Fame numbers will probably not get elected because of confirmed or assumed use), we still see suspensions and new scandals emerging. Sometimes the fall is even more severe – as in the case of former New England Patriot Aaron Hernandez, who is now in prison, charged with murder.
So my question is what do we say to our kids? Are there lessons here?
My bottom line is that we can use these falls as platforms for helping our kids understand that their heroes are people – real people. Perhaps we can encourage our kids to admire their professional successes without making the inference that they are “special” people because of their achievements. We can use these examples to let them know that there are pitfalls in anyone’s life, whether or not they are “heroes.” And of course we can remind them that there are lots of heroes in the world – police and fire personnel, teachers, moms and dads. Anyone can be a hero – and it’s great to remind them that sometimes our heroes are heroes because of their personal characteristics, and not just famous achievements.
Man Acting Like Super Hero via Shutterstock.com
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Thursday, June 13th, 2013
Shaming kids in public has become a parenting trend. You’ve seen the stories. Kids forced by their parents to stand in public holding some kind of sign indicating a wrongdoing. It could be that they stole. It could be that they were disrespectful. But the bottom line is that some parents believe that these kind of humiliating moments – or instances of tough love – may have enough impact to change their kid’s behavior for the better.
So … is this a good or bad idea? While I contend that it’s a bad idea, let’s walk through some of the more subtle points.
We typically hear of stories in which parents are extremely frustrated with their kids. Some are afraid that their kids will get into deep trouble. They feel like they have run out of options and don’t know what else to do. So I understand that they are ready to do something. I’ve seen them in many of my own research studies and have also seen them in juvenile court and understand that they want a solution.
But I suggest that a public shaming is not the corrective measure they are looking for. Will it shock a kid in the short term? Maybe. Will it fundamentally change all of the factors that led to the persistent troubling behavior in the first place? Probably not. And that’s the point.
In practice, and in research, you will find kids with all kinds of problems. Acting out, stealing, lying, cheating. Using drugs and drinking. Being disrespectful. It really begins to hit when they hit the early teens. In order to take on these kinds of behaviors, it’s necessary to work with parents and their kids – using methods that have been proven to work across decades of research – to improve three core parenting skills:
Monitoring: Really knowing who your kid hangs out with and what they do – so you can prohibit or change their patterns of behavior when you see warning signs of trouble. This leads us to ….
Limit Setting: Making sure your kid understands the boundaries you set and learning effective methods for applying them with consistency. This only happens by improving ….
Communication: How many arguments would you imagine a parent has had with a child before resorting to shaming kids in public? Would you anticipate that their dynamics revolve around yelling and screaming at each other? Many times it will. Parents and kids need to learn techniques for improving their level of communication with each other. And parents need to develop communication skills that help them shape their kid’s behavior by being authoritative and not authoritarian.
None of these skills come easily or quickly. They take dedicated effort on the part of parents, kids, and their practitioner. But putting in this kind of effort over time can change behavior – over the long term and not just temporarily.
Frustrated parents and kids who are acting out are realities. It’s agreed that parents in these situations need some type of recourse to right the ship. It can be suggested that public shaming teaches kids about power structures and coercive behavior and teaches much less about learning rules and morality and empathy. What’s really required is that parents and kids have an opportunity to work together to improve their relationship so that parents can be more effective on a daily basis and not feel the need to resort to drastic measures that may not have long-term benefits.
Naming and Shaming via Shutterstock.com
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Tuesday, May 21st, 2013
As a parent, you may be wondering why such a fuss is being made about the release of the DSM-5 (the 5th edition of the Diagnostic and Statistical Manual of the American Psychiatric Association). Here is a brief overview of why it may be (0r become) relevant to you – and why it’s important to learn about the issues that are being debated.
Many Kids Will Experience A Mental Disorder
The primary reason parents need to know about DSM-5 is that many psychiatric disorders that originate in childhood are not uncommon. Consider some rough numbers:
- Around 1 in 50 kids are being diagnosed with Autism Spectrum Disorder
- Around 1 in 10 kids are being diagnosed with Attention Deficit Hyperactivity Disorder
- Around 1 in 10 kids are being diagnosed with Conduct Disorder
- Around 1 in 10 kids are being diagnosed with an Anxiety Disorder
- Around 1 in 10 kids are being diagnosed with a Mood Disorder
- Around 1 in 2 teens have reported meeting diagnostic criteria for at least 1 disorder in their lifetime
Having a good look at these numbers means that lots of parents will be faced at some point in time with the possibility of having their child evaluated for a disorder – and will need to consider treatment options. That’s where the DSM-5 comes in.
DSM-5 Is The Primary Guide For Clinical Diagnosis
The DSM-5 is the handbook used by a broad range of health care professionals who evaluate individuals (youth and adults) for potential psychiatric disorders. It’s an authoritative guide that reflects a consensus statement on the best way to categorize disorders along with the specific symptoms and rules to be used to make a diagnosis. The intention is to make it reflect current clinical thinking that is supported by research. It is not perfect, it reflects a particular point of view by those charged with generating the guidelines, and there is much debate (and criticism) of the diagnostic approach taken by the DSM-5.
All that said, the fact remains that the DSM-5 will be used if you bring your child to a health care professional for evaluation. The clinician will consider lots of information during this process – the DSM-5 does not dictate what information they use and how they get it. It’s intended to serve as a guide to the endpoint of making (or not making) a diagnosis. And it serves as the template for a health care provider to request reimbursement from insurance companies to support treatment.
Why All The Controversy Now?
The DSM-5 is a revision of the prior version which was released in 2000. As such, it includes a number of changes – some of which are minor, some of which are major. Beyond the more general discussions about what’s “normal” and what isn’t, the key things that parents need to know are the practical implications of the changes. As a parent, you should be aware of the changes to disorders that are especially relevant for youth. Here’s a brief overview:
Autism Spectrum Disorder: Major changes have occurred. In the prior version, a spectrum of disorders were available to clinicians, reflecting important variations in symptom profile. Four disorders were listed: Autistic Disorder, Asperger’s Disorder, Childhood Disintegration Disorder, and Pervasive Developmental Disorder Not Otherwise Specified. The key change is that there is now just one diagnosis made of Autism Spectrum Disorder (ASD) – and the other diagnostic categories will no longer be used. Proponents of this change suggest that it is more accurate by defining the core features of ASD that were common to all of the disorders in the spectrum and allowing for differences in severity level under one diagnostic umbrella. Critics suggest that a number of youth who require diagnosis and treatment will not be diagnosed – and that the reliance on severity levels may make it harder for kids with more mild symptoms to receive treatments they need. There’s no answer to these issues yet – they will unfold over time as data are collected. But if your child is evaluated for ASD, it’s in your best interests to be up on the debates and have informed discussions with your clinician in order to make sure you are advocating for the best care for your child.
Attention Deficit Hyperactivity Disorder (ADHD): Minor changes have occurred. In the past, there had to be evidence that a child showed symptoms of ADHD before age 7. That has been extended to age 12 in the DSM-5. There is also more attention to making diagnoses in adults more manageable. All of these changes mean that if you have an older child who has never been diagnosed with ADHD, they might now be evaluated differently. It’s also important to know what isn’t in the DSM-5 – a lower limit on age. That is, there are no guidelines in terms of how young a child may be when making a diagnosis. This is relevant as there have been (controversial) suggestions that kids as young as 4 years of age could be diagnosed (and many in fact have). Know that DSM-5 does not offer guidance here and you will need to make up your own mind if this makes sense for your child – hopefully with the appropriate guidance of a well-trained clinician. Overall, the worry here is that kids of all ages may be overdiagnosed.
Conduct Disorder (CD): Minor changes have occurred. Conduct disorder represents a persistent pattern of rule breaking behavior and behavior that violates the rights of others. It can be diagnosed in young children as well as teens. The primary change has been to incorporate symptoms indicating a callous and unemotional interpersonal style. The thinking here is kids with this profile may be especially prone to experience problems in the future – and require more intensive management and treatment. Be aware that these symptoms will receive more attention now in the diagnostic process.
Disruptive Mood Dysregulation Disorder (DMDD): This diagnosis reflects a major change – it is a new diagnostic category. The idea was to provide a diagnostic option for kids who show persistent irritability and extreme emotional and behavioral outbursts. The rationale for developing the DMDD criteria was to make sure kids who show these symptoms do not get mislabeled as having pediatric bipolar disorder – but still may qualify for treatment. The controversy is that many feel that there is not sufficient evidence to support this new diagnosis – and in the worst case scenario kids who do not have psychiatric problems will be diagnosed with a disorder and get treatment that they don’t need.
Over the next few days, I will publish blog posts that consider each of these four disorders in greater detail, and provide some guidance for parents to help sort through these complex issues. There are no straightforward answers to be found – rather parents need to know about DSM-5 so they can be prepared to navigate the best decisions for their child.
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Thursday, May 9th, 2013
We all know that it is critical for kids of all ages to play. And we know that play can take many forms. But there’s a deeper idea about the importance for kids to learn how to be playful – and how that spirit should permeate their development.
Such is the advice given by Steve Gross, Executive Director – and Chief Playmaker – of The Life is good Playmakers, the action arm of The Life is good Kids Foundation, a nonprofit organization established by Life is good to raise money to help kids in need. Life is good is a company with a positive purpose and is committed to spreading the power of optimism and donating 10% of its net profits to helping kids in need through The Life is good Kids Foundation.
Steve Gross, Chief Playmaker, Life is good Playmakers
The Life is good Kids Foundation directly funds the Life is good Playmakers program. The Life is good Playmakers provide training and support to childcare professionals, who use these tools to ensure that children grow up feeling safe, loved and joyful.
Steve certainly champions the essential nature of play in a kid’s life (“Children need food and water to survive, but to truly live, they’ve gotta play”). But he points out that we often get the message that play happens in a designated time and space and includes specific activities – which means much of the time we don’t harness the power of playfulness in the majority of moments in a kid’s everyday life. He suggests that we want kids to develop the trait of playfulness as a style they bring to everything they do. Steve defines playfulness as “the motivation to freely and joyfully engage with, connect with, and explore the surrounding world.” It’s an attitude, and a style, that provides a cognitive and emotional platform for kids to embrace themselves and fuel for them to bring themselves to the world in a positive way.
Four ingredients make up Steve’s recipe for playfulness:
AFFECT: Kids need to experience joyfulness in their everyday moments – not just the time that’s “reserved” for play. Most of the opportunities for “play” happen in real time. Steve gives a wonderful example of how getting a kid ready to go to play is an ideal time to promote joyfulness – and also a moment that often turns in the other direction for parents. Rather than getting stressed about making sure a toddler has their shoes on and their coat ready, how about treating THAT time as the time to get silly and experience joy and anticipation. It may be even more fun than when you actually get outside to “play.” It’s these little moments that define the affective climate for a child – and bringing anticipation, lightness, joy, and overt silliness to the everyday tasks infuses a kid with a playful spirit that makes most of the day feel like play rather than the other way around.
SOCIAL CONNECTION: Interacting with people is play. It’s as important – if not more important – that your kid is looking at you and seeing you laugh and smile and express joy when you are playing than being engaged in the play itself. Think about all the moments you have to simply talk to your kid – especially babies and toddlers. Don’t underestimate how fun and rewarding (at a very deep level) it is for your kid to explore your face and your emotions and your tone of voice. It’s a constant stream of engaging content for them that they could never find in a toy or a device. So Steve proposes that treating the everyday interaction moments as opportunities to cultivate joyfulness helps a kid discover the power of social connection.
INTERNAL CONTROL: Steve suggests that kids need to feel like they are in control of themselves, and that the world is a safe place for them. They need to feel like they can explore without fear of bad consequences. Sure, you need to keep your kid safe. But a constant stream of “No No No” communicates two things to a little one: the world isn’t safe to explore, and your little one is not competent enough to explore it. One of the tricks of the trade is to practice redirection: rather than saying “Don’t do that!” focus on saying, “Do this instead!” Cultivate the curiosity and direct it in a safe way. That way, you are following Steve’s advice by showing your kid how to explore the world in a safe manner and you are making them feel like they can – and should – follow their instincts to do that.
ACTIVE ENGAGEMENT: One of the wonderful deliverables of playfulness is the ability to be focused and get in the flow of an activity – whatever that activity happens to be. Steve’s conception of active engagement is a core part of what we think of as creativity. Kids need to get lost in the moment, block out everything else, and just follow where the experience takes them. As Steve points out, this doesn’t just happen during what we think of as “play” (although those are of course opportune times to witness this). For younger kids, it can be looking at rocks, following a bug, watching mom put on lipstick, or playing with a zipper on a pocketbook. For older kids, “play” can involve math, English, science, music – whatever turns them on. This all goes to Steve’s overriding message – it’s all about kids bringing a sense of playfulness to everything they do.
In the busy world we live in, we often think it is difficult to find time to play with our kids and give our kids opportunities to play. But if we embrace the philosophy of Steve Gross – Executive Director AND Chief Playmaker of the Life is good Playmakers– we see that we actually have more than enough time to infuse our kids with a sense of playfulness, and a trait that will serve them well for their entire lifetime.
Steve in Haiti
Images courtesy of Life is good
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