Setting Expectations with ALL Kids – Not Just Special Needs

Last updated on October 31st, 2016 at 02:32 pm

On our monthly trip to my son’s orthodontist I witnessed a classic parenting mistake, and I was torn about whether I should speak up. As I sat waiting for my son to be finished a mom came in to the office with her two sons. She was frazzled from sitting in traffic, as we all are in this ridiculously overcrowded city. Her two boys immediately went over to the arcade style video game in the waiting room, which is set on free play.

The older boy kept winning, and the younger boy was getting more and more vocal about his frustration with the game. Every time he shouted out, his mom would say his name in a disapproving tone. He kept shouting and she kept calling out his name, using a gradually angrier tone each time. It was a little funny because she was getting angry at him for being loud but she was being just as loud and making it worse, but I kept my amusement to myself.

Here is what I noticed as an objective observer – she never told him to lower his voice! She kept getting madder while he had no idea what he was doing wrong! I wanted to point it out to her, but I felt it was overstepping the limits of polite society. Plus, I didn’t want to come off as a know-it-all and she was so upset I didn’t think she would really be able to appreciate the help. One symptom of many special needs diagnoses is the lack of ability to control volume or to read social cues so maybe that was part of this scenario. But I wondered if much of the fuss would settle down if she had just explained calmly to him that this was an office where people are working and they need it to be a little quiet so they can concentrate.

Think about the last time you got frustrated with your child, special needs or not. Did you clearly explain what you wanted or needed? I have certainly made this mistake both as a teacher and as a parent and even as a human being. What seems so obvious to one person might be completely unnoticed by or unimportant to another.

Try to be clear with your instructions and corrections, and offer an explanation. Better yet, discuss expectations beforehand – like while you are stuck in traffic. It’s the perfect time to remind your child of what is expected. Social stories can also help special needs kids with new or scary situations as well as remind them of what will be happening and what they can expect. For more on social stories check out this link: http://www.educateautism.com/social-stories.html

AAP Issues New Guidelines for Children’s Exposure to Digital Media

Last updated on March 2nd, 2018 at 12:18 pm

How can a parent know how much technological media is good for his/her developing infant/toddler/child/teenager to be exposed to on a daily basis before it becomes detrimental?  Under what circumstances does it become detrimental?  How do you determine what too much looks like?  It is an especially difficult decision when the devices, programs, and technologies change daily.

In the explosion that has occurred over the past few years, of devices that have gotten smaller, smarter, more compact, offering more options, better graphics, etc., the love-hate relationship has blossomed to levels that invade every phase of everyday living, for all ages, across global lines.

How can you, as a parent, make the judgement call, when even the “experts” were not sure WHAT limits should be set, or even IF they should be set?  In October of 2015, the AAP issued some preliminary guidelines in the form of “Advice for Families on Media Use”.  Up until then, the 1999 guideline was clear; “No screen time for children under 2 years of age.”  That decree was made when TV was THE media in use, before all the new technologies became available.

Finally, as of this past Friday, October 21^st, the American Academy of Pediatrics released, in a streaming Facebook-live announcement, the results of a year-long study of the effects of devices on children in different stages of development.  It also offered specific tools that could be used as the means by which healthy, positive changes could be made as a family, to improve the media experience, while at the same time allowing the other healthy requirements of childhood to be re-established.

Also clearly stated, was that not all of the media programs offered for young children’s viewing as “educational”, are the ones that are approved and endorsed by the AAP as being positive and helpful for that audience, because of the content.  How do you change the habits of your children, if they have been used to being online, on the computer, cell phone, or tablet, etc., for very long periods of time, and from a very young age?  First, you clearly have to identify the problem and its source.  Then you have to establish or change the rules!  And you must stay involved.

The new guidelines that are recommended by the AMERICAN ACADEMY OF PEDIATRICS for media interaction for children, are:

1. Make your own family media use plan.  Media should work for you and within your family values and parenting style. When used thoughtfully and appropriately, media can enhance daily life.
2. Treat media as you would any other environment in your child’s life.  The same parenting guidelines apply in both real and virtual environments. Set limits; kids need and expect them.
3. Set limits and encourage playtime.  Media use, like all other activities, should have reasonable limits. Unstructured and offline play stimulates creativity.
4. Families who play together, learn together. Family participation is also great for media activities—it encourages social interactions, bonding, and learning.
5. Be a good role model. Teach and model kindness and good manners online. Because children are great mimics, limit your own media use.
6. Know the value of face-to-face communication. Very young children learn best through two-way communication. Engaging in back-and-forth “talk time” is critical for language development.
7. Limit digital media for your youngest family members. Avoid digital media for toddlers younger than 18 to 24 months other than video chatting. For children 18 to 24 months, watch digital media with them because they learn from watching and talking with you. Limit screen use for preschool children, ages 2 to 5, to just 1 hour a day of high-quality programing, and watch it with them so you can help them learn from what they’re seeing. See Healthy Digital Media Use Habits for Babies, Toddlers & Preschoolers
8. Create tech-free zones. Keep family mealtimes, other family and social gatherings, and children’s bedrooms screen free.
9. Don’t use technology as an emotional pacifier. Media can be very effective in keeping kids calm and quiet, but it should not be the only way they learn to calm down.
10. Apps for kids – do your homework. More than 80,000 apps are labeled as educational, but little research has demonstrated their actual quality.
11. It’s OK for your teen to be online. Online relationships are part of typical adolescent development. Social media can support teens as they explore and discover more about themselves and their place in the grown-up world.
12. Warn children about the importance of privacy and the dangers of predators and sexting. Teens need to know that once content is shared with others, they will not be able to delete or remove it completely, and includes texting of inappropriate pictures.
13. Remember: Kids will be kids. Kids will make mistakes using media. Try to handle errors with empathy and turn a mistake into a teachable moment.

On an interesting note, for the first time, the AAP has provided recommendations for what they consider to be acceptable content for viewing by young children – for example “Some media can have educational value for children starting at around 18 months of age, but it’s critically important that this be high-quality programming, such as the content offered by Sesame Workshop and PBS.”

Finally, there is a general consensus that the role of technology in children’s lives – and family lives in general – is evolving.  To make it even more challenging, there is NO BASELINE to map against: every child, every family is different and technology will play a unique role in each.

To help families maintain a healthy balance between digital and real life, the AAP has developed an interactive, online tool so families can create a personalized Family Media Use Plan and Media Time Calculator. The Media Use Plan takes you step by step and allocates for each child (based on their age) proper media use such as screen free rooms, screen free times, device curfews, what devices can and can’t be used for what purpose, etc.  The Media Time Calculator (see the example provided here) divides 24 hours over typical activities for each child (again based by age) and allows you as a parent to proactively allocate your child’s day, including their media usage.  It’s incredibly eye opening to see how much time can easily wind up in Screen Time if not allocated elsewhere.

Overall parents – the results emerging from these announcements are positive.  The AAP is looking at digital technology use by families very pragmatically. And like we concluded in our review of their 2015 article  “Beyond ‘turn it off’: How to advise families on media use”,  it is what your child is doing more than purely how much time they are spending in front of a screen that matters…and the fact that you as parents care…and are asking the questions…and are monitoring…is half the battle.

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Reference

• The guidelines above were written from two AAP policies, “Media Use in School-Aged Children and Adolescents” and “Media and Young Minds,” and the technical report entitled “Children and Adolescents and Digital Media,” which were published in the November 2016 edition of Pediatrics.
• They were also drawn from the proceedings of the AAP Sponsored Growing Up Digital: Media Research Symposium, a gathering of media experts, researchers and pediatricians held in 2015 to address new developments in research and media and their impact on children.

6 Ways to Help Ease Your “Clingy” Child’s Anxiety

Last updated on May 28th, 2017 at 12:04 am

Excessive clinginess is a common phase in a child’s early years. It usually starts around 8 or 9 months, peaks at 18 months, and then usually becomes less and less intense, ending around 2 years of age. It is also common around preschool age (the first separation from home) but sometimes is even present in young adolescents in certain anxiety-provoking situations. Though common, it still can be quite unsettling for a parent.

Each child handles stress differently, so the causes of clinginess will be different for each child. A parent’s job is to play detective and figure out what’s causing clinginess. Typical causes include:

• Unsettling or traumatic experience: Bullying, hospitalization, fear of failure, death or illness of a parent, divorce, natural disaster, attachment gone awry
• Sudden transition: Moving, arrival of a new sibling
• A distressing separation: Long separations from a parent, threats of abandonment (“I will leave you if you don’t come along.”)
• Temperament: Some kids are more like tumbleweeds and roll with the punches; others are like orchids, more sensitive, less adaptable and more tightly strung. Twenty percent of 4-month-olds have a biological “nudge” in the direction of increased fearfulness and are a slower-to-warm child.

Typically a younger child will cling more towards their primary caregiver, which is normally mom, and can be quite unsettling for the other parent – usually dad. It’s why it is helpful to understand child development and know that such behavior is normal and will pass.

Parents have to know that research confirms biology is not destiny. Jerome Kagan’s famous Yale studies* with over-anxious kids discovered that when their parents encouraged their kids to spend time with peers and work through their fears, only one-third of the total number observed still showed timid behavior as they entered adulthood.

Here are a few parenting practices that help make goodbyes less stressful:

• Find parental substitutes. Find people she trusts–a babysitter, relative, teacher and friends who know your child’s quirks, routines and likes and dislikes. Gradually stretch separation times and slowly broaden your child’s “inner security circle.”
• Prepare for separations. Studies at Children’s Hospital found that kids whose parents prepared them for a separation were able to leave their parent far easier and protested far less than those not prepared. So drive by the birthday party in advance, go meet the new teacher before the first school day, take an online tour of the school before the move.
• Teach how to “talk to the worry.” Help your child name the feeling, “I’m scared,” then teach her how to talk back to the fear so she is in charge of the worry and not the other way around. The trick is to have her practice telling herself she’ll be okay to build confidence: “Go away worry, leave me alone. Mommy will come back.”
• Rehearse social problems. Set up pretend scenarios and role-play specific social problems, like how to meet a new friend or what to say if a stranger approaches.
• Create “goodbye” rituals. Create a special kiss, or provide a special pebble or keychain to put in her pocket and explain that when she touches it it means you’re thinking of her.
• Be cool, consistent and leave. A kid’s anxiety increases if you make too big of a deal about leaving or draw it out. So stay calm and show confidence in your child. Reassure her that you’ll be back. Promise to return at the stated time. Give her a watch marked with the time you’ll return. Then do so and remind your child that you did. The key is to establish a consistent pattern of goodbyes that build your child’s confidence so she realizes she can make it through the time apart. 

There are three things parents sometimes do that will actually increase clinginess in a child:

1. Parental anxiety. Parental anxiety feeds into your child, so curb your anxiety and watch how you react. Kids can catch our fears.
2. Unrealistic expectations. Too high of expectations can cause a child to believe that her efforts are never good enough and avoid the situation.
3. Overprotection and too much reassurance. Always rescuing or being overprotective robs a child of confidence. The key is to find the balance between pushing and protecting.

Excessive clinginess may be a sign of separation anxiety disorder or another condition, so when in doubt, always consult with a trained mental health professional. As always, trust your instincts. If you’re concerned, get help for your child and don’t wait.

Keep in mind that the goal here is for our kids to learn to cope with life without us, however long it takes.

*Jerome Kagan studies: D. Goleman, Social Intelligence, p. 160.

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Dr Borba’s book The Big Book of Parenting Solutions: 101 Answers to Your Everyday Challenges and Wildest Worries, is one of the most comprehensive parenting book for kids 3 to 13. This down-to-earth guide offers advice for dealing with children’s difficult behavior and hot button issues including biting, tantrums, cheating, bad friends, inappropriate clothing, sex, drugs, peer pressure and much more. Each of the 101 challenging parenting issues includes specific step-by-step solutions and practical advice that is age appropriate based on the latest research . The Big Book of Parenting Solutions is available at amazon.com

Suffering Teen Behavior Issues? You’re Not Alone

Last updated on October 12th, 2016 at 11:26 am

Do you have a young teen who seems to be going off the rails? Like run-ins with the police, getting suspended from school, caught sneaking a beer from the fridge, disappearing overnight, failing an important class after years of mostly “A”s, taking a family car joy-riding without permission. These are all things that friends of mine – and I – are experiencing with our young teen boys right now. I won’t say which kid is guilty of which infraction, in order to protect the…. well, you get the idea.

It’s really hard to know what to do in these situations. There aren’t the same “what to expect when” bibles for teens like there are for babies and little kids. I definitely don’t have all the answers – but I will give some of the things my friends and I are learning on this journey.

First Things First

A friend of mine who is a child psychologist often tells me the following, which I repeat to myself regularly like a mantra: every kid is different and they don’t come with an owner’s manual.

The point of this comment is that we shouldn’t view the behavior issues our kids are having as our fault. We could still be – are – good parents, and our own personal experience of going through childhood and adolescence may not have prepared us for managing the unique child we ended up with.

It’s also important to remember that kids are not just smaller-sized adults. Both their bodies and their brains are still developing – and one of the last regions of the brain to fully develop is the one which oversees decision making and impulse control.

Checking for Underlying Issues

While teen rebellion and experimentation is a fact of life, a change in behavior could be a sign of a problem your child is dealing with. It’s important to try to talk with them to see if something has happened or is bothering them. Getting to the root cause is more effective than just focusing on the behavior issues.

But teen behavior problems could also be due to mental or physical health concerns such as depression, attention and impulse control issues, or other conditions. Getting some professional help can be useful – both for identifying underlying factors and helping your child and family cope. One of the steps they may take are to have teachers complete assessments of your teen’s behavior and temperament to provide additional insight into the situation.

Helping Your Child

Kids – including teens – have a hard time weighing the potential consequences of their actions, to a large part due to their continuing brain development. If you are dealing with normal teen behavior or rebellion, then it can help to concentrate on setting age appropriate rules with firm and consistent consequences. Now, this is one I struggle with…. As much as I try to set rules, my son constantly argues and negotiates – and I have a hard time identifying consequences that work. An article I read recently that I found helpful is at WebMD. They suggest writing out the key rules and agreeing the consequences with your teen(s) – and posting the list somewhere central in the house.

Another thing I’m trying is incentives rather than consequences – something I also picked up from a psychologist. We are having trouble with late assignments at school, so I asked my son what might be a motivating incentive for no “tardy” homework over the next 2-3 weeks. I thought he’d want money or a video game – but he said he’d like to have a family dinner out at a favorite restaurant. That was kind of nice to hear!

Teens are also very poor at judging risk. They often think “it won’t happen to me” when they participate in dangerous acts or risky social behaviors. One thing we’ve seen recently – and tried ourselves – is how to make risk and consequences seem more likely and feel more real.  For example, a friend of our son was recently suspended for breaking school rules. He didn’t think he would get caught….but someone got a picture of him in the act. We talked to our son about this – and how easy it was for someone to get a record of the wrongdoing. We pointed out how lucky he was that no one posted the photo online – which might have made his indiscretion last a lifetime.

In another example, a colleague at work was having problems with his son not balancing school work with his varsity sport. In what I consider to be a sneaky but brilliant stroke of genius, he told the teen he had to drop the sport and made him write an apology letter to his coach. Apparently the boy was beside himself that night – but in the morning, his father told him he could continue on the team if he made a stronger commitment to his academics. He also said to pin the note above the boy’s desk as an incentive for studying – to remind him of how he felt having to drop out of the team.

Helping Yourself

The last thing I would say is that parents also have to look after themselves. One of my friends at work had a really tough time with a wayward son and didn’t realize how much impact it was having on her and her husband until she pretty much had to take a leave from work due to the stress.

If you feel overwhelmed with the situation or find yourself losing your cool too often with your teen, yelling – or crying – and possibly having issues within your marriage as well, you might want to talk to your doctor or a mental health professional. And getting time for yourself – for sports, hobbies, meditation, anything you enjoy – is critical. It’s tough helping our kids when we can’t operate from a position of strength with our own health.

Information for Your Teen about Abuse in Relationships

Last updated on September 19th, 2016 at 06:28 pm

Editor’s Note: *clarification provided for our US readers.

U.S. Resources for Teen Relationship / Domestic Abuse:

• Love is Respect.org – Hotline: 1-866-331-9474 or text “loveis” to 22522
• National Domestic Violence Hotline: 1−800−799−SAFE(7233)

 

OK to Salt a Child’s Food? I Disagree

Last updated on September 18th, 2016 at 05:44 pm

I am a fan of the health and wellness articles in the New York Times (NYT). Their reporting is based on scientific studies and evidence – but the articles are engaging and bring the science down to a more readable level. So, this post is a departure for me, because I disagree with a recent NYT article, by Rachel Rabkin Peachman, on whether it’s ok to salt a child’s food.

The basic argument of the article is that using a little bit of salt on your child’s food isn’t going to add that much sodium – especially compared to how much is hidden in processed foods. And that if adding a bit of salt to healthy but bitter foods, like broccoli, gets kids to eat more of these – then it’s probably worthwhile.

But I strongly disagree.

So What’s the Problem?

First of all, salt intake is MUCH too high in most countries, and this causes serious health issues. In the US, adults and children consume around two to three times more salt than is recommended, most of which is added to foods during processing. The Harvard School of Public Health highlights that these excess salt levels lead to high blood pressure and heart disease – as well as stomach cancer and osteoporosis. Nation-wide salt reduction efforts in the UK, starting in 2003, resulted in a 15% drop in salt consumption and very significant drops in blood pressure, stroke and heart attacks.

And these issues are not just adult concerns. Both the American Heart Association and the American Academy of Pediatrics say that factors leading to high blood pressure and heart disease begin in childhood. Studies have shown that about 15% of kids already have high blood pressure.

Starting in Childhood is Key

Research shows that most food preferences are developed in childhood and are difficult to shift. I’ve seen this first-hand through my own research dissertation for my Masters in Public Health. My project involved qualitative focus group interviews with employees of companies who offer a home delivery service for fresh produce as part of their wellness program. The people I met with struggled to eat the recommended levels of fruit and vegetables – even if they wanted to. Many cited that not growing up eating a large amount and variety of produce set habits that are tough to break and limited their knowledge about healthier cooking and eating.

Ms Peachman’s article states that children who learn to like bitter vegetables with toppings like salt, will like the veggies even after the salt is taken away. Personally, I VERY much doubt that. The study they cited as evidence didn’t use salt, but rather cream cheese – plus another New York times article published in 2011 points out that babies fed higher levels of sodium prefer salty foods when they are older. Again, both the American Heart Association and the American Academy of Pediatrics (AAP) recommend taking the salt shaker off the table – and trying to reduce the sodium kids get through processed food. Kids will learn to prefer less salty food. That’s advice I believe – and how we operate in our house. Now the whole family generally finds that processed and restaurant foods taste too salty.

What to Do Instead?

So, without adding salt, what CAN you do to help kids learn to like certain healthy vegetables that may not be so appealing at first bite? The AAP recommends using other things to alter or boost taste – like herbs, spices and lemon juice.

We do all those in our house. Pepper always gets put on the table, along with Mrs Dash – a salt-free topping. And I use herbs and spices like basil, oregano, rosemary, thyme and cumin. I also brown steamed vegetables, like Brussels sprouts and cauliflower, in a frying pan with a bit of butter or olive oil to add to the taste. Another good option is a little bit of Parmesan cheese sprinkled on veggies – or cooked onions or leeks mixed with veggies like broccoli. See the end of this article for more resources for getting kids to eat veggies.

The point is, there are healthier ways to help kids get used to vegetables – ones that can become lifelong habits without concern.

Tips for Getting Kids to Eat Veggies 

• Fruits and Veggies – More Matters
• WebMD: Raising Fit Kids
• Summer Tomato

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