"The Medicated Child" on FRONTLINE

Frontline is a show I enjoy as an info resource, especially in today's sound byte world because it attempts to stick to the facts and presents more or less evenhanded portrayals of whatever topic it takes on. It's been called "...the last best hope for broadcast documentaries." Coming up on Tuesday, January 8th at 9 pm on PBS they are going to examine the issue of the increase in psychiatric medications being prescribed for children. Their excerpt follows:

Ten years ago, stimulants like Ritalin and Adderall were the drugs of choice to treat behavioral issues in children. Today, children as young as four years old are being prescribed more powerful anti-psychotic medications that are much less understood. The drugs can cause serious side effects and virtually nothing is known about their long-term impact.
The increase in the use of anti-psychotics is directly tied to the rising incidence of one particular diagnosis — bipolar disorder. Experts estimate that the number of kids with the diagnosis is now over a million and rising.

As the debate over medicating children continues to grow, FRONTLINE producer Marcela Gaviria confronts psychiatrists, researchers, and big pharma about the risks and benefits of prescription drugs for troubled children in "The Medicated Child."

Local listings for your area can be found on this page.

A Factor to Consider with ADHD Treatment

I see parents frequently who are wondering whether to have their child assessed, believing he/she might have ADHD. The parents who do go on to have their child assessed and discover their child does meet criteria for the diagnosis of ADHD also wonder about whether to treat it primarily with behavioral approaches or whether to consider stimulant medication. This headline was all over the place recently and is worth considering when weighing all the important variables in an important decision. Study Finds Slower Brain Maturity in ADHD Kids

Crucial Confrontations

I'm in the middle of a book called Crucial Confrontations about how to directly confront peers, supervisors, spouses, anyone when agreements aren't upheld, promises are broken, etc. I'm about half way through with it. I'm finding it quite good, the recommendations specific and realistic and the authors well versed in both psychology and social psychology. I'm already playing with a couple of the ideas. I'll provide a more thorough review soon. The tag line on the cover is "Never walk away from another conflict again."

Happy Halloween. Have fun and be safe out there tonight.

WILD Adventures in the Portland Area

My friend Ronan McCann has been working over the past eight months on launching an innovative non-profit called WILD Inc. (Wilderness Introductions for Learning and Development). The mission is getting city kids out into the wilderness, especially those who don't often have the opportunity. Check out this page to learn a bit more about WILDs goals and what had already been accomplished by the six-month mark—getting kids out in the wilderness, initial partnerships with Portland businesses and organizations, etc.

WILD's website is also a handy resource for Portland families. Practical Adventure Reviews of local hikes rate their difficulty level, provide a photo or two and tips for how you might want to be dressed and prepared. For those hikes that are close enough to bike to or ride Tri-Met to there are links that will take you to ByCycle or Tri-Met trip planning sites that work like MapQuest. There are also links to Google Maps for each of the hikes. The Tri-Met links are a nice touch for making it more practical for families that have transportation challenges to get their kids out to have an adventure once in a while not to mention for families that just like to leave the car behind when they can.

There is also an Adventure Map that has been set up through Google Maps so you can take a quick look at where the reviewed hikes are located. WILD's site really is nice if you find some time where you want to get in a weekend hike and you want to use the internet to plan a trip. Take a moment to bookmark it at ChildrenOutside.com and check out the features when you have some time or as soon as you get the urge to get the family out on a path. WILD will undoubtedly enrich the lives of all sorts of Portland families.

While We're At It: Praise that Doesn't Help

Since that sleep article of Po Bronson's was so good I checked out some more of his pieces. This previous one from New York Magazine on "How Not to Talk to Kids" is very solid as well. I have a lot more thoughts on what sort ways of talking to kids are helpful and which are counter productive that will show up on here eventually. But for now Bronson's piece nicely takes us through how our attempts to praise often end up getting in the way of our kids succeeding. For those of you who don't have time to read this now, I'll just say that it focuses on being specific and on praising effort rather than "being smart". There are measurable differences in the way kids respond to these ways of interacting with them. A focus on effort rather than on "innate intelligence" equips kids to keep at it when things get difficult. Kids who hear a focus on how "smart" they are rather on how hard they worked tend to give up when faced with a task that is challenging. This is even true of very intelligent kids. They are more apt to conclude that if they don't succeed right off the bat, it is evidence that they aren't all that smart, and it becomes too risky for them to persevere.

I recall an article from years ago that highlighted this difference between American and Japanese students. American students who ran into challenges were more likely to conclude they weren't smart enough, whereas Japanese students tended much more often to come to the conclusion that they needed to roll up their sleeves and work harder. And their tendency to move toward harder work translated into more academic success.

Photo by Phillip Toledano is from the New York Magazine article.

How to Help Kids Get The Sleep They Need

Both this side bar and the recent New York Magazine article are worth checking out. If your time is limited just take a look the sidebar for the practical tips on helping your kids to get enough quality sleep. If you've got some time to read the feature article by Po Bronson you can get the gist of some recent research that shows some of the more severe effects of kids getting too little sleep. It turns out that not only problem behaviors can result from being under rested, but even significant cognitive declines that really add up.

Thanks to Heather Decker for passing this article along.

Beyond Lectures, Part 2

We looked last time at how lecturing, though it comes to us easily, isn't all that helpful to helping kids along the path to responsibility. In fact, I would agree with several folks in the business of working with families that kids who receive a lot of lectures actually tend to be less responsible. We also looked one of the best ways to avoid lecturing when we're frustrated with our kids' behavior, which is to wait until a time when we're both feeling calmer. Jim Fay's mnemonic suggestion for this is "Save the words for the happy times." I would add that just going for a more neutral time is often enough. Once you've used a little shared control to set up a time to talk, there are lots of alternatives on how to have a helpful conversation.

We know that it usually helps and almost never hurts to use some empathy. When someone has demonstrated that he can see our situation the way that we experience it, it is a human tendency to be more open to accepting influence from that person. This makes a good deal of sense. When we're pretty sure that someone has next to no idea what an experience is like for us, it simply wouldn't make a lot of sense to take advice from that person. Some empathy might sound something like this:

I'm guessing that getting chores done isn't one of the things that you look forward to when you get up...not one of the highlights of your day.

It probably isn't much fun having me getting cranky with you about your not getting them done.

Initially when we think about using empathy as a parent, it can arouse some resistance on our part. "Why should I be empathetic? He's being whiny and irresponsible. I work all day, and I get my share of the housework done. Why should I be having to come up with empathy?" My main response is that it is important to keep your goal in sight. If the goal is to get the chores done, equip your child with the skills to be responsible, and to maintain a sense of connection with your child, it is useful to begin with empathy. If Dr. Phil agreed with my suggestion on empathy and he were to respond to our natural resistance to this idea, I could just hear him say in his drawl, "Look someone's got to be the adult around here. Looks like you're the only likely candidate"

In addition to empathy, something else that can be helpful is to use questions that elicit how our kid sees the situation. "So what are some of the challenges in getting your chores done?" This can help kids to become involved in the conversation. Instead of feeling criticized for their lack of responsibility they might be more likely to help identify what they problem is, which by itself will make it more likely that you'll be able to come up with some sort of workable solution.

Now that you've got your kid closer to being on the same wavelength, one way to proceed is to use collaborative problem solving. This sort of approach to finding solutions actually works much better if it is done visually on paper, or ideally on a big white board or butcher paper up on the wall. Step 1) Define the problem. Step 2) Brainstorm a lot of possible solutions to the problem, with everyone involved contributing ideas. It important at this stage not to edit ideas. We come up with much more creative ideas when we aren't simultaneously editing or critiquing thoughts as we're coming up with them. Step 3) Circle the solutions that seem most helpful. Step 4) Identify one or more possible solutions and give them a road test. Finally, Step 5) evaluate how it went and revisit the process as necessary.

So when you're tempted to lecture, wait to have the conversation until you're calmer, use some empathy and give collaborative problem solving a try. This is certainly not the only way to avoid the erosion that lectures can have on responsible behavior and on your relationship with your child, but it can be one effective route.