The Rules: Keep It Simple

When it comes to parenting, sometimes less is more.  While I'm certainly an advocate of intentional parenting, sometimes standing back and letting things go has it's merits.

Have you ever heard the term, "helicopter mom?"  Hovering leads to exhaustion, which leads to burn-out, and at the exhausted and burned out level, parenting is no longer enjoyable.  "Rules before relationship equals resistance."  Resistance is the level where the fun goes out of parenting.  If parenting becomes all about the routines and the rules, there is little time left to enjoy the relationships that made us all want to be parents to begin with.

A few ideas about keeping rules simple:

• Ask yourself if a rule is necessary for the situation.  Example:  No singing in the car.  That actually used to be a real rule at our house...until the rule became far more annoying than the singing.  The reason behind the rule:  We have a daughter who used to love to sing.  Her rule was to sing anytime, anywhere, the more singing the better.  But what's a girl to do when her brothers think singing is annoying?  Most of the time the answer was (to the brothers), "Go do something else."   Or if she'd been singing for a long time, she could go finish singing in her room.  But what about in the car?  The brothers couldn't get away, and the sister was only happy if she was singing...but since the brothers couldn't get away, the new rule was announced:  No singing in the car.  Then one day a song came on the radio that everyone but one family member wanted to sing.  The one family member whined the whole time that the rule was:  No singing in the car.  Get the picture?  As situations like that came up, it became apparent that the rule created more problems than it solved, and the rule was absolved in favor of lessons about courtesy and kindness.  It's working.  (Mostly.)
• Try the umbrella rule policy:  If one rule "covers" the others, try eliminating a few.  What do the following rules have in common?  1) Don't ride your bike without a helmet.  2)  Wear your seatbelt.  3) Don't leave toys on the stairs.  4) Don't throw things in the house.  See a common thread?  Hint:  They all have to do with safety.  Try the next list:  1)  Eat your vegetables.  2)  Wash your hands after using the bathroom.  3)  Brush your teeth morning and night.  4)  Clean your room.  What do they all have in common?  Hint:  The answer is health.  Imagine being able to replace those 8 rules (and numerous, numerous others) with two rules:  Be safe.  Be healthy.  Then when a child forgets to buckle up, or forgets to wash hands after using the bathroom, simply ask, "Was that safe?" or "Was that healthy?"  Umbrella rules tend to focus on "being" qualities rather than "doing" tasks.  Children gain judgement from learning to generalize a way of being across a variety of settings vs. applying a rule to a limited setting.  Rules like safety and health can encompass everything from cleaning up after yourself to not licking your fingers at the dinner table.  You can ask:  Is it safe to leave your toys on the stairs?  Is it healthy to lick your fingers while you're eating?  Qualities or characteristics important to your family become the new umbrella rules, and can eliminate tedious enforcement.
• Avoid black and white thinking:  In psychology black and white thinking refers to a specific type of thinking error where absolutes are the norm.  Black and white thinking reflects fear and uncertainty of anything unfamiliar.  In parenting it reflects a need for control, and leads to despair and resorting to extreme parenting when things don't go as planned.  Black and white thinking traps parents in a corner.  What is meant to limit and restrict paints rigid lines around a situation that don't allow for flexibility and growth...and certainly limits the quality of relationships.  Parents who engage in black and white thinking find themselves emotionally exhausted, with children ill-prepared to face the variety of life circumstances that only expand as they get older.  Such examples in parenting include:  We don't allow internet in our house.  If you don't like rules, that's tough.  Lying is bad.  All rock music is evil.  Somewhere between black and white lies grey.  If the horrible possibilities of the internet are frightening, try making a list of what you'd like your child to know in order to navigate the internet safely and sit with them while you learn how to navigate the internet together.  Could time limits instead of restrictions solve media problems?  What about lying?  Is it ok to lie if you're planning a surprise party, or talking about the Tooth Fairy?  If a child is lying to get out of trouble, it could be an opportunity to examine what in your relationship with them has them concerned about the rules and not feeling like they can come to you to work through difficult situations.  If lying is bad, does that make the child bad also?  Black and white thinking leads to generalizations about self-worth in children.  Try flexibility instead.

Certainly, rules are an individual parenting decision.  Families need rules to function, but children need flexibility and guidance to grow into human beings that can handle a variety of situations rather than limiting behaviors in a few isolated settings.  Sometimes less really is more.

Mothers of Special Needs Children

In a few days it will be Mother's Day.  Moms:  May your day be filled sticky hugs, sloppy kisses, and a refrigerator front filled with hand-made cards and neatly scrawled sentiments about mothers.

Do you know a mother of a special needs child?  Are you the mother of a child with special needs?

The job of mothering is a difficult one at best.  It is filled with sacrifices, battles, and thankless tasks that never seem to end.  Whether you're married or single, rich or poor, domestic diva or kitchen klutz; whether you're a stay-at-home mom or you work outside the home, or whether you're a mom to children by birth or adoption...or simply by nurturing and loving all the children you meet...  No matter your individual circumstances as a mother, you know that mothering is one of the most difficult and challenging tasks women share.

Add to that the task of parenting a child with special needs, and the task becomes exceptionally difficult and challenging.  I realize that special needs is a broad category.  It can include (to name just a few) parenting children with behavioral and mental health challenges, children with complicated medical histories, children who suffer trauma and abuse, children who are adopted, children who struggle to learn, children who struggle to make friends, children with any range of developmental delays, children  who struggle with physical limitations and disabilities, and many many other possible combinations of complications parents face raising children.

In my mental health practice, I help parents and children deal with a variety of the issues mentioned above, and almost always, by the time I see them, they've tried multiple interventions, been to doctor appointments of multiple specialties, struggled in school, and struggled at home.  They're frequently the object of comments from others, sometimes well-meaning, and sometimes just mean.

One of the first things I find myself discussing with parents in this situation is their own mental health, self-care, and support systems in dealing with the complications of raising a child with special needs.  I want them to know more than anything that it is not bad parenting that causes psychiatric, behavioral, or developmental disorders, but it takes an exceptional parent to dig down deep into reservoirs of untapped strength to raise this child.

That said, the risk of burn-out to parents of children with special needs is high.  Elizabeth Blackburn (winner of Nobel Prize for Psychology or Medicine 2009) studied mothers who raised special needs children over the course of ten years.  She found that mothers of special needs children experienced a shortening of telomeres (protective end of chromosomes).  This process could cause an average of 9-12 years decrease in life expectancy of these mothers.  This is a biological condition similar to what is experienced by combat soldiers.  Increases in other hormones associated with stress also contribute to autoimmune disorders, diabetes, and other chronic health problems.  Certainly, constant stressors of that level go beyond those experienced by other mothers.

It is not only a good idea, but a necessary one, for mothers of children with special needs to seek support and care for themselves.  Here are some ideas of how that can be accomplished.

1. Build Social Supports:  Although difficult to build and maintain, support systems are life-saving.  Social supports are often the only source of much-needed respite.  Many parents of children with special needs say that as they try to build social supports through traditional means (church, school, neighborhood, work), their special needs children create too much stress for friends and other parents to understand and their support systems disappear.  This can be a huge barrier to finding social support, and many parents give up.  Consider social support in tiers with community support being the outer tier, a layer which many families don't have to access frequently.  Children with special needs often have access to community or school programs and resources that other children don't have.  Start with those groups and make friends with like-minded people who can share in child-care and other ideas for respite.  As you do, the outer tier of support becomes an inner, more natural support system.  Also consider looking for funding for respite care provided by trained caregivers.  There are also support groups for parents of children with special needs where it is possible to connect with other parents and build support systems.  Family is another source of built-in support.  If you have children with special needs and live far away from family, ask yourself:  Who lives locally who can give me the same support?  Do you have friends or community groups who have become like family to you?  If not, is it a possibility to move closer to family?  (I work with one family who recently relocated from another state for that very reason and it has made a huge difference in the couple's marriage to have additional support.)  And just a caution:  While internet groups can be helpful and provide sources of contact and information, they lack the human touch that will decrease stress hormones and provide hands on care and support that parents of children with special needs will require.
2. Take Care of You:  Moms of children with special needs will frequently say they don't have time for themselves.  I ran a group for parents of children with special needs for several years, and I was persistent at getting parents to identify things they did for themselves each week during our group check-in.  At first there weren't many responses, but after the question had been out there for several weeks, I started to get answers:  I started taking vitamins...  I went to the doctor...  My mom watched my son while I got a pedicure...  I went out to dinner with my sister...  I painted my bedroom...  I started taking walks with my son...  I went back to bed after my child went to school...  Moms in the group even started sharing ideas of where they could get low-cost haircuts, nails, massages, etc.  All the little things you do for yourself add up to decreased stress and improved health.  If the well is empty, you can't give what your child needs most.
3. Accept Things As They Are:  It's difficult to know when to be a mom warrior (required for mothers of children with special needs) and when to let it go.  If you're starting to feel like you're fighting just to fight...for something...anything...that could help your child, then do a quick assessment of your efforts.  How much time are you putting in?  What are the results?  Are the difficult lifestyle and dietary changes making a difference or are they complicating life in hopes of making a difference?  Are you spending hundreds of dollars a month on supplements and procedures that promise hope and don't deliver?  What would you do with that time and money if you didn't have to make those efforts?  Certainly health is important, but truly assess the progress of your child under each intervention.  Interventions should produce progress, and if they don't, consider different approaches.  Seeking healing and improvement is certainly a necessary part of treatment, but also consider the long-term effects of constantly trying to change or improve the disability vs. enjoying the unique abilities of that child or your family.  Also consider the needs of other family members and the impact of interventions on their sense of normalcy.  Family life is important also.  Interventions are excessive if they take away from every day human interactions (which by the way, are very healing).
4. Don't Forget to Live:  Most likely, the challenges of special needs aren't going away.  As stated above, expend a reasonable amount of effort into the care of your child, but don't forget to live.  Do you enjoy life?  Do you enjoy relationships?  Do you enjoy your children (even the ones with special needs)?  Do you have hobbies and interests outside your children?  Do you and your spouse share a relationship that isn't focused on parenting and medical or therapy visits?  I know one family raising a child with autism who leaves him with family while they go on vacation.  He hates vacations anyway.  It took them years to get to that point, but they enjoy their other children in a different way and notice that their bonding and interactions with their other children improve during those times.  They say that when they look at family vacation pictures, there is always a little pang of sadness that their child with autism isn't a part of those memories, but they celebrate a life they now enjoy when managing his melt-downs no longer controls their lifestyle, and their child with autism is much, much happier in his own home under the watchful care of relatives who are willing to provide that support.  That may not be the answer for everyone, but it is an example of adaptations that work.

The task of parenting special needs children is a difficult one.

Remember:  It takes an exceptional parent to dig down deep into reservoirs of untapped strengths to raise this child.

The honest truth is this:  If the reservoirs aren't there, the unique things you have to offer aren't available either...  Your experience is uniquely your own.

Don't forget to live!

(If you know a  with a special needs child, consider watching their child, or taking them out to lunch...    Celebrate their experience in motherhood.  Help them build their circle of support.)

Cultural Competence

Like many others in my local community, I've been following a recent news story about acts of racism in a local high school.  I happen to live within the boundaries of Alta High School, and naturally as a parent and citizen of the area, I have concerns.

In a nutshell, a student recently participating in a school spirit rally put a white pillow case over his head and was making racist comments.  A follow-up letter from local school district representatives acknowledges the incident and also identifies concerns about other incidents of racism which were uncovered as well during their own investigation.  You can read more about the story here.

The purpose of discussing this issue isn't to point fingers or assign blame or further divide an already divided community, but hopefully to educate.  The truth is if we can't learn from incidents like this, we're bound to repeat them.  We live in a world that has come a long way, and yet at the same time we live in a world that deals increasingly with a lack of civility on both sides of polarizing issues, and reactions to this recent community event are no exception.

As parents and adults, we have an obligation to live and teach cultural competence.

Culture is defined as the behaviors and beliefs of social or ethnic groups.  This could include patterns of language, thoughts, actions, beliefs, customs, values, a variety of other subtle forms of behavior and living.

Competence is defined as possession (and I think internalization) of skills, knowledge and capacity in a particular area.  Implied in that definition is the ability to function effectively in that singular area of competence.

I believe that cultural competence is a way of being and living.  It is difficult to teach without experiencing.  It involves awareness of one's own self and world view, as well as an understanding that we are surrounded daily by others of diverse experiences and views.  It encompasses the very real, very human qualities of being able to interact and connect with other human beings across cultural boundaries, whether those are boundaries of nationality, religion, race, gender, sexuality, economic status, or political views (or any other area of cultural difference).

Here are a few ideas about developing cultural competence in our families and communities and teaching it to our children:

Personal and Family Cultural Competence:

1. Develop confidence in who you are as a person.  Awareness of one's own culture and belief systems leads to increased flexibility and tolerance of other cultural and belief systems.  Rigidity in beliefs and culture promotes isolation and ethnocentrism.  Be aware that confidence and awareness of your own belief doesn't require validation from others.  It's an internal sense of competence that comes with aligning lifestyle choices with belief patterns, and allowing others the same right.  
2. When incidents arise such as the one described above, can you see both sides?  Allow flexibility and empathy in your responses to situations which challenge cultural competence.  Balance your views with statements of understanding about opposing views.  Encourage family discussion of events that explore looking at issues from both sides.
3. Be aware of language.  Leave out words that isolate based on culture.  Only bring up cultural differences in conversation if it is relevant to the conversation.  Avoid discussing your "black friend" or your "gay friend" or your "non-religious friend."  Substitute words such as "they" or "those people" with specific and politically correct references which acknowledge the pride of other someone else's background.
4. Whether you see America as a melting pot or salad bowl, acknowledge all backgrounds as essential to who you are individually, and who we are collectively as a country.  Throughout the course of our history, many ethnic, religious, and cultural groups have been objects of discrimination as a result of egocentrism and ethnocentrism.  Diversity is what makes us uniquely American.
5. When you travel or attend cultural events be respectful of diversity.  Politely engage in learning about differences and culture without making judgements.  Be aware that your views seem just as foreign to others as theirs might to you.  You've heard the term "ugly American."  Travel and participate in cultural events as a polite guest.

Teaching Cultural Competence to Young Children:

1. Become involved in learning about other cultures in a non judgmental way.  Participate in school projects where other countries and cultures are discussed.  
2. Don't point out differences to children unless they notice first.  Children are naturally curious and they will notice differences, and parent response to them noticing is important.  Parents should not pass judgement on differences, nor should they pass judgement on a child for noticing differences.  This is where individual confidence and awareness of one's own culture and world view are noticed by children.  When a child notices differences, engage in a discussion about what they have noticed using respectful and politically correct language.  After you feel they are satisfied with the answer, lead the conversation to a discussion of similarities.  Help children understand that we all have different families, but we all love our families.  We all have different religions, but religions help guide our lives and decisions.  We might have different economic statuses, but we all work and provide for our families in ways that work for our own circumstances.  We might have different skin color or eat different food, but we all have hearts that love and tongues that taste, and bodies that work and function in the same way.  The possibilities for discussing similarities are as broad as the possibilities for discussing differences.
3. Discuss positive and negative aspects of all cultures, including your own, with respect.  When children hear parents reference their own culture in a negative way, they struggle with their own feelings of self worth and belonging.  If you disagree with negative aspects of culture, such as political or religious views, voice the disagreement as a personal view that acknowledges diversity, such as, "Other people believe......., but I believe..........."  
4. Use family situations to build a sense of individuality by acknowledging diversity in your own family.  Maybe you have family members with different food, clothing, or music preferences (or a variety of other preferences).  Validate the differences by allowing choice, and helping siblings to support the choices of each other.  If Danny has to attend Jen's ballet recital, it's ok to acknowledge that Danny doesn't have to like ballet to support his sister (and vice versa).
5. Limit television, computer, or gaming options that promote violence and disrespect.  Humor in children's programming is increasingly focused on sarcasm and disrespect.  Children see characters in media programming hurt and disrespect others, then see them return to being friends again with no real acknowledgement of the hurtful effect of that kind of behavior.  Watch those types of programming with them and point out the disparity in entertainment vs. real life.
6. Engage children in games to help them understand things from other points of view.  They can "look through someone else's eyes" to imagine what they might see.  Use magic glasses to make it fun.  They can play this game during sibling and friend disagreements or when they are being rigid about their own point of view.  Also try looking through the eyes of a third party (the dog, a visitor from Mars, etc.) to help them learn to describe objectively what they might see.

Cultivating Cultural Competence in Teens:

1. Be respectful to teens about their individual choices of friends, clothing, activities, music, beliefs, etc (as long as their choices are legal, safe, and healthy).  Teens, will demonstrate increased respect of other's choices and diversity when they are respected.  
2. Teens are developing their own sense of self and a healthy part of that development is world view.  Discussions of current  local and world events will spill over into home.  Teens say things to "get a reaction" or test and try new ideas in safe environments, such as home and school.  Allowing discussion of new ideas is a part of identity formation, and allowing discussion doesn't equate support of ideas.  Acknowledge the formation of your own beliefs.  When discussing your own point of view, don't use popular rhetoric to back it up.  Let them see that you've thought and explored ideas your self and come to your own conclusion based on exploration and gathering information.
3. Encourage respect and civility in conversations.  When you notice disrespect in conversations and dialogue with friends or family members, redirect without criticizing.  Start a new conversation or guide the conversation in a different direction.
4. Encourage teens to become involved in community organizations and community service to increase awareness and understanding of diverse groups and populations.  Teen years can become imbalanced with individual goals, routines, and pursuits.  It's healthy to help teens become involved in their communities.  Ideas for service and involvement don't  have to be expensive or time consuming to be engaging.
5. Make relationships important.  Relationships influence and guide thinking.  Teens align themselves with sources of validation.  If parents and community leaders respond in validating ways to teens, they become sources of influence rather than obstacles to be opposed.  
6. When you see flagrant acts of disrespect and discrimination, intervene regardless of whether you think it's popular.  Frequently teens pretend to go along but wish someone would intervene when things get out of hand because they are unsure of how to respond themselves.  Taking a stand and stopping "fun" at the expense of others sets an example of defending civility and respect.  Be prepared to offer acceptable alternatives to inappropriate behaviors or behaviors that lead to others being hurt or disrespected.
7. Help them own bad choices without identifying them as "bad."  Adults frequently fall into the trap of justifying their children's behaviors to protect them.  In reality they are being protected from life lessons that will help them increase judgement that is forming during teen developmental years.  Adults just as frequently come down hard on teens.  They need to be loved to learn.  As much as possible, let consequences be natural results of their choices. 

As parents and community leaders, we have to be aware that respect and civility are the heart of developing cultural competency.  We are obligated to be as much as we are obligated to teach.  When we respect ourselves and others, we set the tone for children to follow.

Day Three: Energy Matching

Have you ever noticed days have energy?  There are days with high energy, low energy, and everything in between.

Have you also noticed that children always have energy?  And most of the time they aren't stressed.  The energy of the day doesn't seem to matter to them.  Unless there is something seriously wrong in their world, they meet the day with enthusiasm and excitement.

Adults, on the other hand, are prone to low energy levels and high stress.  The combination of an adults low energy/high stress level, and a child's high energy/low stress level can often lead to family explosions.

So how do adults manage such hazardous combinations?

The solution is to moderate energy output to match the energy and stress levels of the day.  The first focus and priority should always be relationships, and other demands can be adjusted.

On a high stress, low energy day, adding more pressure can only lead to more stress, and eventually explosions.  If you're having one of "those days" it might be a good day to order pizza and watch a movie.  Or go out to eat.  Or let the dishes sit in the sink and play.  It sounds like a no brainer, but how may people do you know who pressure themselves to get everything accomplished on their daily checklist but hurt the people they love in the process?  When there is a limited amount of energy available, conserve for important relationships and make adjustments to external demands.

Of course there are a number of stress/energy combinations, and children don't always fall into the high energy/low stress category.  Parents should be aware of children's energy and stress levels and adjust demands as necessary.

Ultimately, as we match the energy of the day with reasonable expectations of ourselves and those around us, the possibility for shouting, yelling, or harsh responses is decreased.

Good luck keeping up with the challenge!

Considering Development In Goal Setting

How many slams in an old screen door? 
Depends how loud you shut it. 
How many slices in a bread? 
Depends how thin you cut it. 
How much good inside a day? 
Depends how good you live 'em. 
How much love inside a friend? 
Depends how much you give 'em.
~Shel Silverstein

Curiosity compels children to be natural learners.  With constantly developing minds and bodies they are compelled by development to learn and try new things almost daily.  But age is an important criteria in determining how formal the goal setting process should be.

Toddlers and Preschoolers:

1. Goals based on accomplishment of a specific task are not necessary up through preschool years.  At this age, achievement should be limited to developmental tasks.
2. A parent's role at this age is to provide structure, boundaries and opportunities to succeed at various tasks.  At this age, children have vivid imaginations, which can be engaged through play as they learn new skills.  At the same time, their lack of ability to separate reality from fantasy creates unnecessary disappointment and an artificial sense of achievement if children are exposed to highly competitive activities.  Look for activities where participation and skills building is rewarded over keeping score or performing.
3. Connecting goals to developmental tasks eliminates the risk of tying self-worth to elements beyond the child's control.  Eventually they will accomplish developmental tasks.  If they are behind developmentally, reward attempts and approximations to keep them trying.  Seek professional help if concerns about development continue.
4. Help unmotivated children make a game out of frustrating developmental tasks such as dressing, buttoning, zipping, tying, and cleaning up messes.  The presence of a parent in accomplishing developmental tasks increases the firing of neurons in a child's brain, and their opportunities for success at tasks increases.
5. During these years, children develop emotional autonomy, and are great at giving natural feedback about whether a goal is theirs or not.  (What parent hasn't heard "No!" from their toddler?)  Children circle through attempting autonomous tasks and returning to their parents for support.  If parents are dismissive or inattentive, children become more easily frustrated because they can't connect with needed support systems.  Many behavioral concerns start at this age if children are compelled by parent response (or lack of) to engage in attention seeking behaviors.  Similarly, when parents force ideas, goals, plans, etc. on children at this age, they will retreat emotionally and become insecure.  Balance and support are key to achieving success at this age.

Elementary School Years:

1. Beyond the toddler and preschool years, competence becomes a major milestone for emotional development.  In typically developing children, this milestone takes place between the ages of 7 and 11 years old.  Not coincidentally, at the same time children are mastering this stage of development, their intellectual development becomes oriented around problem solving.  As children's minds are naturally compelled through development to combine problem solving with a drive for emotional competence, this becomes an ideal age to introduce goal setting.  
2. As children set and reach goals, they gain a greater sense of self determination and begin to master the skill of combining their own unique problem solving abilities to guide their life and behavior.  
3. Goal setting can help children start to understand connections between their personal choices and end results.  Again, reward approximations and attempts in children who have difficulty accomplishing tasks.  In the absence of feeling competent, children begin to feel inferior about their abilities in relation to their peers.  
4. Parents can discuss goals with their children but choices and ownership are important to the accomplishment of emotional, cognitive, and physical development at this age.  Parents can offer choices, limits, and support in guiding the goal making process.  For example, it is acceptable for a parent to allow a certain number of activities, or to offer rewards for participation in things children might not attempt on their own.  Again, rewarding the attempt becomes important at encouraging children to continue trying.  
5. If children suggest goals where the outcome is out of their control (such as making 5 new friends at recess), parents can redirect the goal to something within their control (such as saying "hi" to 5 new people at recess.)
6. Goals should be individual.  I once heard a mom say in therapy, "Everyone in our family plays sports, so she needs to choose a sport.  And dancing is not a sport."  What the child heard was:  I don't belong to this family, and what I value and want to be good at isn't important to them.  Encouraging individuality encourages exploration and healthy development.

Teen Years:
(No, the words goal and teen are not oxymorons.)

1. Put your relationship first.  Teen development is based on physical and emotional autonomy.  They naturally pull away from parents, but when parents can exist in a supportive role, teens continue to turn to their families for support.  (Support does not mean enabling.)
2. Teens have likely already developed interests and feelings of competence in certain areas.  Continue to support them in these pursuits, but don't be surprised if their interests change.  Teen years are also a time where they experiment with identity.  They discover which parts of their identity are more fixed (such as race, gender, culture, etc.) and which parts of their identity are unique (talents, abilities, hobbies, interests, religion, etc.).  While there are a number of factors that affect the successful formation of identity, certainly one of those is control of the parts of their lives that make them unique.
3. Even if...  Control over their future becomes important even if...  Even if you spent thousands of dollars on dance lessons and now they're done dancing.  Even if they're poised for an athletic scholarship for college.  Even if...  You get the idea.
4. But not if...  Control over their future is good, but not if...  Not if their choices about their future involve hurting themselves or others.  Not if their choices about their future involve illegal activity.  Not if their choices aren't safe.  Not if their choices aren't healthy.
5. The same push-you-away and pull-you-close routine that took place at two is taking place again during the teen years.  Be there when they need you to be close, watch from a distance when they need freedom, as long as their choices are safe and healthy.  If you burn the relationship bridge by withdrawing approval and affection, you've lost the opportunity to give any input at all.
6. Support new interests.  If you encourage healthy exploration you help your teen understand that possibilities aren't fixed, and they become lifelong learners.  Remember:  "Even if..."
7. Don't tie their accomplishments to your ego.  It isn't necessary to draw a lot of attention to interests and abilities.  Some kids my like the spotlight, but most will withdraw if parents take ownership of interests and accomplishments.  Support becomes a secondary role at this age.

The sky is the limit!

Goals: Yours or Theirs?

I've said before I don't watch a lot of TV, so I know I was probably the last one on the planet to there was a television show called "Toddlers and Tiaras."  This show chronicles the lives of children and their families as they prepare for and participate in beauty pageants.

Last week when I couldn't sleep I found myself channel surfing and came across this program.  The contestants being followed included an infant whose mother said she "prayed to God for the next Miss America."  Mom also spray tanned her infant prior to the pageant so she could win the grand title.  After the infant didn't perform she was given "special juice" which was a caffeinated beverage, then in commenting on her infant's performance, the mother felt bad for her infant and was sure she was disappointed.  (I'm sure the child's only disappointment was not getting her nap that day.)

Another 5 year old contestant was forced and threatened to practice for the program, then held her down and forced her to get her eyebrows waxed prior to the pageant.  When the daughter's tantrum escalated during the eyebrow waxing, the mother blamed it on an earlier bad experience with eyebrow waxing.

Really?  It's not normal to scream if you're restrained and tortured?

And what happened after the same mother hauled her screaming daughter away from the cameras while threatening her?

In my mind this show is wrong on so many levels I don't even know where to begin.  Don't get me started on the fact that there weren't boys in this competition, or that little girls (future women of America) were being judged on poise and beauty...  And I'm sure those same mothers' eyes would glaze over if we started a discussion over infant brain development, sleep and caffeine.  So for today let's keep it simple.

If we're just sticking with the January theme of goal setting, it begs the question:  At what point does the goal belong to the child, and at what point does it belong to the parent?  (And I'm sorry, but you can't argue for a minute that an infant had a goal to win a grand title of a beauty pageant, or that a five year old woke up one morning and asked to have her unibrow waxed.)

Guidelines For Parents:

• Fragile egos:  Parents with fragile egos often tie their own success as parents to the accomplishment of their children's goals.  It is important to support your child's self-determination and development, but if you find yourself too emotionally connected to an outcome, step back and evaluate.  As parents, when we see our children as amazing individuals, their wings will take them in a lot of directions we might not have ever dreamed for them.
• Are children achieving goals or developing as healthy, autonomous individuals?  If their lives become a checklist measured by points, grades, scores, and titles, they risk losing the individuality that makes them a human being.  If goals get in the way of development or relationships, set them aside for a while and evaluate again later.
• Attempts:  Don't expect perfection.  Encourage children to set goals in increments.  Reward attempts and approximations, even imperfect ones.  A shot that comes close to scoring is worth recognition.  A grade that comes close to passing might reflect a last minute effort.  Art with realistic displays of flaws could be the next Van Gogh.  
• Build on strengths:  Think of something your child already does well and encourage expansion.  Do they already enjoy reading?  What reward might they earn if they choose to read a new genre of books?  Do they love basketball?  How can they safely explore a new sport without failing?
• External vs. internal motivation:  Offer rewards for trying new things or achieving goals as needed, but also look for opportunities to develop internal motivation.  What encouragement can you give that would provide the same motivation as an external reward?
• Create a supportive environment.  Provide daily routines and structure which supports a balance of free time and working toward homework and other tasks, including daily chores. Check your environment for things that distract from accomplishing goals such as noise confusion, clutter, and changing expectations and make modifications where possible.
• If it doesn't work out:  Goal achievement is based on typical physical, emotional, and mental development.  If children fall outside of this category, it is easy to become discouraged.  Remember that You Are A Good Parent and your journey may not be the same one your friends are taking.  Your path and your child's path is no less important.  Seek help as needed, and be amazed at what can unfold.  Disabilities might even lead to huge contributions.  You may or may not have heard of Temple Grandin.  She is an adult with Autism and a PhD who was named in the 2010 edition of Time as one of the people who most affect our world.  She said, "A treatment method or educational method that will work for one child may not work for another child."   If it doesn't work out, it may be the method, and not the child that is broken. 

Look for more information next week on age appropriate goal setting.

Parent/Neurologist

My sister's email signature reads, "Paths are made by walking!"  Interestingly enough (and not surprising to those who know me), I have always pictured a brain when I read that, and think of the neural pathways that are formed by human actions and interactions.  Fascinating if you think about it, that a series of responses can become a pathway which once traveled, can't be untravelled...  Or can it?

The theory of neuroplasticity isn't new, but it's a concept which is gaining momentum in the world of behavioral and neuroscience, and is a critical part of any parenting discussion.  After all, we can all use a do-over once in a while!

Parents, did you know you are neurologists and neuroscientists?  Neural pathways are formed in brains by human experience (primarily attachment experience), beginning from birth.  Children's development is dependent on the quality of early relationships, and throughout the course of our lifetimes, when faulty pathways are formed, it is frequently through human connection and interaction that new pathways are formed in their place.  Although most neural connections are formed in the first three years of life, our brains are constantly developing.  As new neural pathways are formed, our brains "prune" or get rid of unused pathways.  Experience is the main factor in determining which pathways are used and which are pruned.

Ideally, all children would be born into loving attachment relationships with all the neurological developmental processes in place to take advantage of every learning opportunity that comes to them.  In reality, many children are victims of developmental trauma and neglect, and still other children are born with dysfunctional sensory processing and modulation systems.  The acquisition of learning and skills in difficult in both cases, but not impossible if you believe in neuroplasticity.

As parent-neurologists, you have the ability to form and strengthen neural pathways with every interaction you have with your children.  Because human beings are social/relational creatures, we know the strength of connections is increased with the excitability of human interaction, particularly within the context of attachment relationships.  This of course makes healthy attachment critical, but in cases where attachments are dysfunctional, other significant adults can also become neurologists in the process of developing neural pathways.

Following is a model which can be implemented with children of all backgrounds and developmental abilities.  It's a model that is both borrowed and original (or rather borrowed pieces to the point that it is a combined original).  The goal is to use the parent-child (or adult-child) relationship to help achieve a state of emotional and behavioral self-regulation.  This model pre-supposes adult self-regulation, and frequently when that is a problem, I work with parents in therapy to get to a point they feel comfortable regulating their emotions enough to implement this type of process.

Ready for action?

1. Remove the stimulus.  When a tantrum or melt down occurs, there is usually someone or something which can be identified as the "stimulus."  The object or individual should be removed from a setting long enough for the child to redirect focus from an event/object to the overall goal of self regulation.  Side note about time-outs:  The concept of "time out" has become so distorted that the focus is number of minutes, or "time served" vs. the real goal of learning self-regulation.  If a child can return to a regulated state in 5 seconds, why do they have to sit somewhere for 5 minutes?  Neural pathways are forming during that time, and if they calm down and immediately receive positive feedback about this accomplishment, a neural pathway has formed, and their brain knows what to do the next time.  If they calm down in 5 seconds and have to spend the next 5 minutes in time out, what neural pathways are formed during that time?  Are they "thinking" about what they did?  Really?  More likely they're thinking about how unfair this is, and plotting ways for pay-back against who or whatever got them into time-out.  It's better to use time-out for emotional/behavioral regulation.  The "thinking" comes later.
2. Ensure predictability and safety.  During the removal of stimulus, does the child know what is expected?  Will they get the toy back or be able to return to the activity when they are calm?  Clearly state the expectation and limits.  Adults can help ensure safety by making sure that the "time out" location is as stimulus-free as possible so children do not become destructive if they are angry (more about how to handle that later in the process).  If children are physically fighting, adults should be aware that safety comes before emotional regulation.  Children cannot regulate unless they feel safe.  If they are carried, dragged, our forced into another setting, this often increases physical aggression as a normal "fight or flight" response.  In spite of fighting back (and especially when fighting back) children are seeking the security of knowing what to do.  Angry reactions are frequently a response to fear and happen in the absence of other skills.  Alternatively, adults can communicate they are in charge of the "time-out" by stating, "It looks like you're taking  your time-out right there.  I'll stand here with you until you're calm and we can talk about what happens next."  The plan of refusing to comply with specific time-out requirements is thwarted.  Who says time-outs have to take place in a corner?  The goal is emotional self-regulation, and forcing compliance can derail that process.
3. Identify target emotional states.  It frequently takes children who are distressed a long time to calm down.  If there are "lulls" in the tantrum, an adult can identify that as a calm emotional state.  True story:  I had a mother once tell me that she had this in mind while her daughter (who had attachment disorder) was calming down.  She said it was taking forever for her to be calm, and she couldn't find a pause to identify any emotion that was remotely close to calm.  At one point her daughter was sobbing and she gasped like people do when they have been sobbing for a long time.  As she drew in a breath, her mother quickly noticed and said, "Oh, you calmed down just for a second."  That small identification of "calm" gave her daughter a target and literally within seconds her daughter drew another breath and her mom identified "calm" again.  When the daughter returned to crying, it was more of a "fake cry" for a few minutes, interspersed with "calm" breathing.  As the crying decreased, the mother identified to her daughter that the crying wasn't as loud and it sounded like she could calm down.  The daughter acted upset at the mother telling her this, but she allowed it and continued to allow her self to be guided in the self-soothing process.   Interestingly enough, tantrums after that were lessened significantly.  Mom used a calm emotional state to help the daughter to self-regulate, and the daughter's neural pathways for self regulation continued to form.
4. When everyone is calm, talk about the behavior.  Parents think they have to talk about behaviors right when they happen.  Children as young as three or four are capable of remembering earlier behaviors.  Parents can identify the positive (the child is calm) and agree to have a talk about the behavior later.  "Later" when you have the discussion, identify target behaviors.  Let the child know if they become upset or whine, the discussion has to take a time-out until later, but no toys, TV, etc. until the discussion has taken place.  The child's natural drive to return to activity is on your side!  This step sometimes requires going back and forth between step 3 and 4 until a conversation takes place in a calm emotional state.  It is critical for everyone to be calm during this phase, because in a state of dysregulation, the brain's main goal becomes survival, and cognitive neural pathways are not formed in extreme emotional states.
5. The discussion should include three main components:  a) What happened?  b) What could you do differently? and c)  How can you fix it?  A variety of responses are acceptable.  Adults should not be looking for "right" responses.  The only "right" response is the child having a thought process about their actions and thinking through problem solving and repair.  As this process is repeated (The first thousand times are the hardest!) they form cognitive skills that can override emotionally dysregulated responses.  It's all about forming neural pathways.  If the words come out of your mouth "telling" them the "right" answer, they'll nod agreeably so they can return to their activity, but the only neural pathway being formed is the one that says, "Nod and smile when adults speak to you so you can get out of uncomfortable interactions a lot faster!"  No matter how long it takes, the responses should be their responses.  If their answers are inappropriate, you can redirect the responses with more questions rather than telling them the answers.  The "How can you fix it?" portion of this discussion is a great place to introduce the concept of destructive behavior.  If the child was destructive during the tantrum, help them fix what was broken or work with them to earn money for a replacement so they recognize what happened.  The next time when they're upset and begin destructive behavior, the new neural pathway in their brain will recognize the prompt of "We'll have to fix that later," if they choose to break something.  (It may take a lot of fixing broken things to get good results.  Neural pathways take time to form, hence the caution to make the time-out location be as stimulus free as possible.)
6. Recognize the need for early redirection.  Children often give signals they are beginning to get overstimulated, which may lead to a meltdown.  It's easier to prevent and redirect negative behavior than to stop it.  If you see the signals (hyperactivity, change in tone of voice, not responding to redirection, etc.), suggest an alternate activity before the child gets to a dysregulated state.  If they learn to redirect, this also becomes a neural pathway.  As adults, we "redirect" all the time by taking breaks.  Notice the need to redirect, but only draw attention to the more calm, redirected behaviors.  If transitions are difficult (as they often are in children with developmental delays) you may have to engage them in an alternative behavior you know they are interested in as you make a transition.

Again, the first thousand times are the most difficult.  You'll forget.  They'll forget.  You'll get distracted.  You'll be exhausted and need a few time-outs yourself.  Neural pathways take time to form.  Think of a brain injury or stroke patient working with a physical or occupational therapist.  It takes literally hundreds and hundreds of attempts and repetitions to regain skills lost to injury.  The same may be true for children who have not had a typical course of neural development.  The point of encouragement is that change is possible.  Brains are plastic...and you're now a neurologist!

Say No To Drugs

In 1985, Enrique (Kiki) Camarena, a drug enforcement agent for the DEA, was close to exposing a multi-billion dollar drug pipeline when he was kidnapped and killed by some of Mexico's leading drug traffickers.  Saddened by the loss of a great officer, friend, and family member, those closest to him organized community groups to speak out against drug trafficking and to make drug free pledges in his honor.  Participants wore a red ribbon, symbolizing their commitment and pledge.  Thirty years later, Red Ribbon Week has become one of the nation's largest drug awareness programs.  Schools, businesses, media, community, and faith based organizations continue to sponsor drug free awareness events to publicize what is now known as  "Red Ribbon Week."

Earlier this year I volunteered with PTA to help with Red Ribbon Week events at my daughter's school.  Early in the planning process, we thought it would be a great idea for every Sunrise Elementary student to be able to plant a red bulb that would come up in the spring, reminding students of their promise to grow up drug free.

What was I thinking?!?

Dig a hole, throw in a bulb, cover it up.  How hard can that be?  Not so difficult, really.  ...Times 760 students and 29 different classes...  Thankfully a small army of parent volunteers made "Plant the Promise to Grow Up Drug Free" a huge success.  The final bulb went in the ground this afternoon, and with any luck, there will be 760 red tulips surrounding Sunrise Elementary in the spring.

Through the week as each group of students came outside to plant their bulbs, we engaged them in a short discussion of the importance of growing up drug free.  The other volunteer coordinator of the project shared with me today that a little girl in one of her groups said something about her mom not being healthy because of taking drugs and drinking alcohol.  Off and on through the planting process I heard a few other similar comments, and even specific references to drugs by name and terms associated with drug use.  It was disheartening to think that for some of the students, the only positive discussions they will ever have with adults about drugs comes from PTA volunteers.

At the same time I heard comments which reaffirmed what a powerful force parents are in the goal of helping children to grow up drug free.

"My parents talk to me about drugs," one girl told me.

"I know how to plant bulbs because I plant them with my mom," said another boy.

My favorite was from a fourth grader who had to dig a hole in a difficult spot of ground.  As he dug he told me how strong he was, and said, "I get it from my dad," then added, "I'm growing up to be just like him."

Parents, you really are the anti-drug.

There is a lot of current research supporting the role of parents in drug prevention.  In fact, most anti-drug campaigns target parent involvement as the key to children and teens avoiding drug traps.  When teens are surveyed about influences that keep them from trying drugs, parents are at the top of the list.  Yes, they really are listening.

Other ideas for helping to prevent drug abuse:

• Talk early and talk often.  Preschool is not too early to introduce discussions about drugs.  At this age there should be a foundation and vocabulary for discussions that will follow.  They can know there are drugs to help you when you're sick and drugs that make you sick and unhealthy.  They can know that drugs should come from a doctor and they shouldn't take them unless their name is on the label or prescription.  
• By early elementary school, children will hear references to drug use from peers and media.  A foundation of previous drug discussions leads progressively into continuing discussions about drugs as children's awareness grows.  Parents should let their children talk about the things they hear without discouraging the discussion or labeling it as "bad."  This is a great age to start referring specifically to health risks of smoking and alcohol abuse.  As you see advertising about cigarettes and alcohol, view it as an opportunity to point out myths associated with advertising and to discuss how the job of companies is to make money by getting people to buy their products.
• Later in elementary school children may start to seem bored with discussions about drug and alcohol use, but parents should initiate discussions, especially when opportunities present themselves (a unit in school, a drug reference on TV, etc.)  Many opportunities for discussions at this age occur informally, while driving, while engaging in an activity together, etc.  These are natural opportunities for discussion about the effects of drinking and driving, or the effects of drugs on health that might prevent engaging in sports or recreation.
• The same is true for teens, with a twist.  Teens have to develop autonomy.  That's the developmental goal of the teen years.  Parents have to strike a balance between involvement and control.  Ask questions, but be sure to avoid interrogations and make your questions come from a genuine interest in your child's life and friends.  Also, don't stop taking advantage of natural opportunities for discussion.  Let teens know that privileges are an extension of responsibility.  Love is extended unconditionally.  Trust is earned.  (I can love you enough to help you get where you need to be, but if you crashed my car three times last week, I probably won't trust you with the keys.)  

And a few more important ideas:

• Pre-teens and teens will know peers who become involved with drugs.  Parents should be empathetic to the conflicting messages and emotions their children will process as they see others go through drug use or experimentation.  It can be confusing and hurtful to see a peer go through changes in behavior, academic performance, etc.  Parents should not read empathy for friends or desire to talk about a friend's drug use as a desire for their child to be in the same situation.  Mostly they will want to talk and (even though they won't say it) they're looking for support and validation as they form their own ideas and opinions about the world.  Look for signs they want to talk, and be available for the really difficult conversations.
• If children or teens experiment with drugs, parents should value their role as allies in fighting against the drugs, not in fighting against their child about drugs.  Battles create a wedge.  Empathy creates a bond.  The rules and limits should continue to be clear, but should be enforced with love.  Parents should understand enabling behaviors, and understand the difference between being a parent and being a friend.  
• If teens are experimenting with drugs, parents should seek professional help.  Many parents ignore early warning signs and think they can fight the battle alone.  Addiction isn't about behavior, rules, or ability.  It's about overcoming strong chemical and biological urges created by substances which alter brain chemistry.  Early intervention is key.  It's a myth that someone using drugs has to hit "rock bottom" before they can get help.

Like the small army of volunteers helping students to "plant the promise," it takes a small army to help kids win the day-to-day battle against peer and cultural influences.  Parents lead the army.  Without you, it's a difficult battle to fight.

Do-ing vs. Be-ing

A 9 year old boy once said to me in a therapy session, "We are human beings, not human doings."  When he said this, I was sure he was just about the smartest 9 year old I had ever met.  Since then I've heard that quote other times, in other places, enough to know that it probably wasn't his original thought, but I do think often of the wisdom in that quote, and often wish that our western world would slow down just a little bit so we could really enjoy the "being" part of our nature.

We've all heard of the Type A and Type B personality theory.  Type A personalities are described as having a sense or urgency and importance about everything they do.  They are competitive and achievement oriented, and place less emphasis on relaxation and fun.  Type B personalities are described as the opposite.  They're patient, relaxed, and easy-going.  Lacking a sense of urgency, they seem to live in the moment without a lot of concern about direction or choice.

Personally, I identify more with the former category, and have wished my entire life to be a little more Type B.  I must have had some success, because my husband (a Type B) frequently describes me as a Type C personality, which, in his words, is "Type A about turning into Type B."  At least he can have a sense of humor about it...and that would be the Type B in him again.  Go figure.

The healthy truth is that balance is good.  We are human beings, but we wouldn't survive without doing, and as parents, it is important for us to be able to model a healthy balance of being and doing for our children.  It is critical to the development of self-worth.  An over emphasis on doing creates anxiety and stress.  An over emphasis on being creates apathy and indifference.  Neither is healthy.

In reality, it's difficult to strike a balance.  How do you get an overly anxious child to relax and enjoy life?  And what about the child who refuses to even acknowledge the existence of homework?  Is there any hope at all?

Think of this as an experiment.  You acknowledge that self worth in children comes from feeling valued, and know that you play a critical role in the development of self-worth.  Then, as with all experiments, you can't be sure where it will lead, but all attempts are feedback which will lead to new discoveries and new experiments.  (Safety goggles are not required but should be available in case of emergency.)

• Start by taking a few days to notice what you value in your child.  Do they make you laugh?  Are they smart?  Do you have a self-starter?  Are they kind?  Make a list...or not.  What did you notice?  
• Notice your reaction when you see what you value in your child.  Did you smile?  Did you acknowledge it to them?  Remember, every child deserves to look into the face of a parent and see delight.
• Decide which of the things you value would go in the "doing" category, and which would go in the "being" category.  If you're the list making type, would the "doing" list be longer than the "being" list or vice versa?
• Think of a small step that might help balance the list.  If your child is loaded with "being" traits, how can you encourage more "doing" qualities?  Would adding/removing motivators help them move toward a goal?  If the "doing" category is becoming a little too heavy, how can you encourage your child in more of the "being" traits?
• Use your relationship with  your child to help accomplish more balance in being/doing categories.  When you join with your child in what it is you would like them to accomplish, they are more likely to engage.
• Catch your child doing things in the area that seems most unbalanced.  If your child is content to just be, catch them working toward a goal and become excited about it.

Warning:  It is also important to be aware of the uncomfortable emotions that come up in the process of this experiment.  Being aware can lead to acknowledgement of difficult and sometimes painful feelings about parenting.  Not acknowledging those feelings can lead to resentment, which certainly your child will hear in your voice and see on your face.  It's all feedback to a child.  Disapproval can inadvertently lead to feelings of low self-worth.  Noticing the uncomfortable might be a step best accomplished in small doses, and if you find yourself stuck in the process, try talking it out with a spouse, a friend, a sibling... or a therapist.

Remember, start small.  The goal is balance.  As a recovering Type A personality, I can honestly say the grass is green on both sides of the fence.  There is a lot to be gained in those being moments, and starting small can actually be the most rewarding part of the process.  Don't worry about staying too long on the observation phase of your experiment.  You'll be surprised what happens through observation alone.

Just notice.

Notice your child.

Notice your reactions.

Notice their responses to your reactions.

Notice them.

And tell them you noticed.

You Are A Good Parent

Theme for October...drum roll please!

Ok, so I'm not really sure I have a theme for October yet, but parenting has been on my mind a lot lately, so I'll go with that.

"You are a good parent."

...Words we love to hear, but don't hear often enough.

Prior to starting my private practice I led a weekly parent-child relationship group.  It was part of a cluster of groups where parents met in one room while their children met separately to work on social and relationship skills.  The children of said parents were kiddos who struggled in practically every setting.  They were children with Autism, ADHD, Anxiety, Depression, PTSD, Attachment Disorder...and the list goes on.  Parenting these children was a particular challenge, hence the parenting group.

Needless to say, parents often come to group exhausted and discouraged, with little progress to report, and they were honest about it.  Parents new to the group were always pleasantly surprised and relieved to hear they weren't the only ones struggling.  Group check in frequently became an update on the week's disasters.  It wasn't uncommon for parents to keep tabs on whose son or daughter was kicked out of daycare or suspended from school.  Parents often expressed frustration at hearing well-meaning peers, co-workers, neighbors, and teachers hint that their child's problem was a case of bad parenting.  I believe, and frequently tried to reinforce to the group, that they were exceptional parents who were dealing with issues that many parents will never experience; problems which required them daily to reach down deep inside themselves to find a level of parenting they didn't know existed.

I remember one week that seemed abnormally tough for most of the parents.  During our group check-in, I heard parent after parent describe their week.

"My son dumped craft paint all over a newly painted, newly carpeted room at daycare.  On purpose!"


"We had a huge meltdown at the grocery store and I have huge bruises on my legs and arms from trying to carry my son to the car."


"Someone called DCFS on us...same neighbor, for the eighth time."

I could tell that on that particular night the group needed a little more than the usual "hoorah" for their efforts.  Earlier that same week I had watched a television interview on the news of a mother discussing her toddler's recovery after he had nearly drowned in the bathtub.  She had stepped away for only a minute, but that's all it took.  During the television interview the mother said, "I know I'm a good mom."  That statement stuck with me because I could tell when she said it she believed it.  Inside I celebrated because I knew that her little boy would not have to grow up in the shadow of his mother's guilt at having walked away from the bathtub for only a minute.  She could forgive herself.  They could enjoy the gift of life they had been given.  In the heirarchy of importance to a child, it was a blessing equal to that little boy's life.  Every child deserves to look into their parent's eyes and see delight.  (See more on the story here.)

As I shared the story with my group, a mom in the back of the room started to cry, first little tears, but before long she was sobbing.     Other parents shared tears as well.  One by one they began to express hurt and anger at the the invalidating things they so often hear from others about their children.  It seemed that everyone had an opinion about their child, and everyone had advice, yet no one but them had to walk in their shoes all day, every day without a break.  In the fatigue of their lives, fun was often lost to function, and they were operating in survival mode.

Under ordinary circumstances, being able to say, "I'm a good parent," isn't always easy.  We beat ourselves up for everything...missed appointments, late homework, dirty laundry, a sink full of dishes.

I've done it too.  On the day of the group I mentioned above, I remember listening to the group and thinking about my own day.  I hadn't left myself enough time that morning and had rushed my kids, and doled out my own share of mommy guilt for being impatient with them.  I had also remembered half way through the day that I missed a soccer sign up for my daughter.

So how much more difficult is it for parents of children with emotional and behavioral difficulties, who hear constantly about the problems their child is having, to feel good about being a parent?  It isn't what they expected it would be, and everyone and everything in their world reinforces to them that they should be different, or their child should be different.

I came across this online video again a few days ago, and posted it to facebook.  It's an essay by Emily Pearl Kingsley, the mother of a child with Downs Syndrome.  Emily was a writer for the PBS children's program, Sesame Street.  Early in her career, Emily gave birth to a son with Downs Syndrome.  Subsequently, she used her work to create awareness of children with special needs, and people with disabilities were often included in the show's programming.  I think she beautifully captures what it means to be the parent of a child with any type of disability.



Remember:  "You are a good parent."  Go hug that kid and tell them you love them and are glad you're on this journey with them.

Getting Involved

I've already said that I learn a lot from children.  Such was the case last weekend when our family participated in a charity fundraiser, organized by my nephew, Stephen.

Earlier this year, Stephen attended a meeting where representatives from Free the Children presented the audience with the idea of using your personal gifts, combined with issues you care about to improve the world.  This concept inspired Stephen, who (with a lot of help from his mom) organized Water Walk Utah.  The goal was to raise money to build a well for a village in Kenya so that children who carry water long distances to help take care of their families would, instead, be able to attend school.   Walkers who signed up hoisted whatever water they could carry the distance of a 5k.  Stephen's goal was $5,000.00, the cost of drilling one well.  By the end of the day Stephen had raised over $8,000.00 to contribute to Free the Children, and raised awareness around the issue of educational opportunities for children in another part of the world.

Here in our own country, where education is considered a right protected by law, the issues are different.  Partly because of Stephen, and partly because I've been posting about similar issues lately, I'm more aware of discussions going on around me about education.

At the beginning of the week I was with some other women who were talking about the new documentary Waiting For Superman, which had been featured on The Oprah Winfrey Show.  I'm not sure where I've been lately, but I hadn't heard of the documentary before that conversation.  (No offense to Oprah.  I just don't watch a lot of TV.)  I was both intrigued and validated by this conversation; intrigued because of the level of concern surrounding the issue, and validated that I wasn't the only one concerned about the quality of education in our country.

As the week progressed, l began hearing snippets of discussion about President Obama's comments on The Today Show (NBC), also addressing the quality of education in our country.  Through the week various discussions around the issue of educational quality have taken place on NBC's Education Nation.  Regardless of your politics, the need to discuss and be involved in the issue of education isn't new, and clearly continues to capture universal interest.

Below are some additional resources that provide more information about issues facing education, and give ideas for individual action and involvement.  No effort is too small.

• PTA (Parent Teacher Association) is a great connection between schools and parents, and offers a lot of information as well as opportunities for involvement, fundraising, and community outreach.  If your school is not affiliated with PTA, get involved in your school's individual parent-teacher organization.
• NEA (National Education Association) and NEA-parents both offer unlimited resources, ideas connections, and opportunities for involvement for both parents and professionals.
• PIRC (Parent Information Resource Center) offers state by state directories, contacts, and resources available to parents as well as free online learning opportunities and opportunities for discussion.

Could it really be as simple as the idea that inspired Stephen to action?  Start where we are.  Do what we can.  Get involved.  Ask questions.  Think innovatively.  Be informed.  Follow the formula that inspired Stephen:  Your gifts + Your issues = A Better World.

The other day I was cutting out a label on my daughter's ballet skirt.  The white label showing through the sheer black fabric bothered me (and her), so it was coming off.  As I cut the label, I glanced at what I was throwing away.  Size...just a number.  Company label...don't need it.  Care instructions...here I paused to read.   Wash with similar fabrics, tumble dry low, do not iron...all potentially important instructions, but I'd just have to rely on memory and common sense.  As long as that annoying white label wasn't showing, it didn't matter.

Maybe you get where I'm going with this.  How important are labels in helping to educate students with disabilities?  Like the label in my daughter's dance skirt, most disability labels aren't pretty.  They're functional.  If we remove the label, can we trust our common sense to provide for a child's educational needs?

There's a lot of information out there cautioning against labeling children, and the concerns are valid.  1)  Self fulfilling prophecy:  Do children come to identify themselves and their abilities based on a label?  2)  Over diagnosis and over labeling:  Do schools (and mental health practitioners) diagnose more than they have in the past and is a diagnosis really necessary?  3)  Generalization:  Labels are, by nature, generalizations.  They fail to recognize a child's unique limitations and strengths.  4)  Socialization:  Even though children with disabilities often struggle socially, there is criticism that labeling could cause the child to be singled out further by peers.

We're all familiar with individuals we know personally who we think may meet the criteria for diagnosis of a mental health disorder.  Maybe.  Maybe not.  A serious mental illness is partially defined by a lack of functioning in daily life skills.  If children can compensate and function in school and home environment, a diagnosis may not necessarily serve them.  You've heard the saying, "If it ain't broke, don't fix it."

So to label or not to label?  And does labeling help a student who is struggling academically?

The answer to that question is more likely to be individual than general.  Each parent and educator has to examine the pros and cons for students on an individual basis.  Personally, I'm not opposed to labeling a child if it helps in treatment and access to services in schools that can help a child succeed academically.  That said, here are a few tips and cautions to consider in the label or not labeling debate:

Tips:

• Seek accurate and differential diagnosis.  Work with clinicians that coordinate care with multiple resources, including school and medical professionals.  Collaborative efforts lead to a more clear and accurate picture of what is happening with a child.  I've seen parents complete an evaluation form for ADHD where all the criteria pointing toward a diagnosis were marked, only to have the teacher complete the same evaluation form for the same child indicating that the child meets few or none of the diagnostic criteria in the school environment (and vice versa).  Generally, to meet diagnostic criteria, symptoms exist across a variety of settings.   
• Which leads to the next tip:  Rule out other causative factors first.  Perhaps there is something going on in the home or school environment that better explains the child's symptoms.  Perhaps there is a dietary or medical condition contributing to the symptoms.  This is actually fairly common.  Everyone is different, but personally I'm in favor of the lowest level of intervention possible which is best accomplished by examining a wide range of contributing factors.  
• Medication may not be the intervention of choice for every child, but in cases where medication is indicated as the best treatment option, a diagnosis (label) is necessary.  As I've already said, I'm a huge fan of ruling out all causative factors and focusing on moderate interventions first, but that's not the answer for everyone.  One of the most important developmental tasks of school-aged children is to develop competence.  This requires self-mastry, relating with others, engaging in social relationships, and completing tasks successfully, all of which are difficult for children with any type of mental disability.  If medication can help a child achieve that particular developmental milestone with success, it should be considered as a treatment option.  
• Trust your instincts.  Parents generally know their children better than anyone else and should never apologize for advocating for their child.  Professionals have access to information parents don't have which could be helpful to the parent and the child, but the application of that knowledge is incomplete without guidance from the people who know the child best.  Parents, don't abdicate your judgement to professionals.  Ask questions, get answers, then make a decision that you feel is in the best interest of your child.

Cautions:

• Don't use (or allow the child to use) the label as a crutch.  As a practitioner, I am disheartened when I hear a parent or teacher refer to their child (even indirectly) as incapable because of a diagnosis.  Children with ADHD can do anything other children can do.  They might have to do it differently, but they develop that all-important sense of competence when they are given skills to succeed.  Similarly, children's negative behavior should not be dismissed because of a diagnosis.  A diagnosis is not a get-out-of-life free card.  Frequently I ask parents to picture their child with a physical disability, maybe dwarfism, or a hearing impairment.  Would you want that child to never pursue the same goals and ambitions as other children simply because of a disability?  Or picture an adult criminal who justifies a crime because they happen to have some type of disability.  None of us want to live in that kind of world, and learning the connection between actions and consequences starts before adulthood.
• Next, parents should not rely solely on school resources for diagnosis and treatment.  School systems do a great job of educating children.  As part of that educational process, they are required to maintain a staff of professionals to help children succeed academically.  Professionals such as teacher's aides, speech and language pathologists, school psychologists, and occupational therapists (among others) are hired by a district and are frequently spread between several different schools.  Their focus (as it should be) is on helping children to function in the school environment.  Functioning in a school environment is important for future success, but functioning across all settings is also important.  Include professionals in your child's treatment that will collaborate with school professionals on treatment rather than relying completely on school professionals for treatment.
• Don't give up!  Every school, class, teacher, and intervention is not right for every child.  Too often I see parents react angrily when their child's needs aren't being met in school.  The child's needs are best met if parents keep trying.  The answers don't come immediately, and schools are operated by human professionals who do their best to help children succeed.  There is no guarantee of perfect results.  We know that, but it's difficult for parents to remember when they see their child struggle.  As parents of children with special needs know, there are good days and bad days (even though sometimes it seems as if there are only bad days and worse days).  Tomorrow is a new day.  Try something new.  It might work.  

Returning to the ballet skirt example, there will be times when a label clearly doesn't serve a purpose.  Common sense and good judgement are sufficient, and the freedom of removing the label outweighs the need for the label.  There are other times the label may contain detailed and important information.  Like clothes, not all children are of the wash and wear variety.  Some require specific care instructions or services to continue to function.  In the school setting those special care instructions come in the form of IEP's and 504 Accommodations.  (Look for the next post about using these resources and accommodations to help children in school.)  Unlike the very general dry clean only instructions in clothing, they're specifically tailored to the educational needs of each child and can be a great asset to children, parents and educators.

The bottom line:  It's up to you.  Don't be too quick to get out the scissors and start cutting if a label is the source of meeting your child's needs.  Ask questions and trust your judgement.  This is your journey.