Category Archives: Learning

To Spank or Not to Spank? That is the Question!

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As my private practice continues to grow, I find it has become more difficult to keep up with blogging. My new goal is to try to complete a new entry at least once per month. Here we go:

Parents often ask me about spanking: Is it o.k. to spank? Should I try another type of discipline? My child doesn’t respond to timeout—what should I do? And on and on…. It is a controversial topic and one on which many parents disagree.

After 30 years in public education and 1 ½ in private practice, I have never waivered in regards to my feelings about spanking. I don’t believe any type of physical hitting or violence is ever justified. Although my own children will tell you that I have raised my voice on more than one occasion when feeling an urgent amount of stress, I never resorted to hitting, spanking or any physical violence as they grew up. I think it’s fair to say that all parents want to raise kind, motivated, responsible, non-violent and confident children. It is my personal and professional belief that hitting and/or spanking actually undermines these goals.

Just this week, an article in the journal Pediatrics outlined the results of a study titled Spanking and Child Development Across the First Decade of Life, in which researchers examined the relationship between spanking and children’s behavior and vocabulary through age 9. Parental reports of spanking were assessed at ages 3 and 5, along with instances of aggressive behavior.

Overall, 57% of mothers and 40% of fathers engaged in spanking when children were age 3, and 52% of mothers and 33% of fathers engaged in spanking with children at age 5. Maternal spanking at age 5, even at low levels, was associated with levels of child aggressive behavior at age 9. Fathers’ high-frequency spanking of children at age 5 was associated with lower child receptive vocabulary scores at age 9.

The authors concluded that not only is spanking still used as a typical form of discipline by many American parents, but also that spanking has proven to have negative effects on both the behavior and cognitive development of young children.

I found this study to be interesting for several reasons: 1) The actual percentage of “spankers” was a bit higher than I realized; 2) Throughout my career, I have consistently counseled/educated/voiced my opinion to parents about the importance of NOT spanking, hitting or perpetrating any form of violence on their children, thus this study validated my beliefs; and 3) the study is current, had a large sample, and used a control population, deeming is scientifically sound.

Like many things, it’s easy to tell parents NOT to spank, but that’s just not enough—we must provide them education about other more healthy techniques for managing their children’s behavior (see my earlier posts about time-out, for example).

More emphasis needs to be placed on providing children the tools necessary to resolve conflicts without hitting, to manage stress in their lives, to learn empathy for others and to communicate and interact with others respectfully. Spanking is a short-term response that ultimately fails to teach children what we want them to learn over a long period of time.

So, if To Spank or Not to Spank is the question, the outcome of this study suggests that Not to Spank is most definitely the answer.

Please tell me how you feel about this topic by leaving a response above.  If you feel that you need to speak to a helping professional, contact me, your child’s teacher/school, or seek counseling from a reliable therapist. As always, thank you kindly for reading.

Woo Hoo! Back To School! (Part 2)

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Part 1 of my back-to-school blog covered basics of ensuring a smooth transition for you and your child(ren) as a new school year begins. This post focuses on the back-to-school “jitters” and those children who truly get anxious.

Not only do students encounter beginning-of-school jitters, but teachers and school staff also feel the emotions of a new year, a new beginning.  I worked in schools for 30 years and can safely affirm that I rarely had a good night’s sleep the night before school started.  It’s a natural phenomenon to get excited, scared, eager, or overwhelmed at the start of something new. Although some accept change with ease and slip into new experiences with little fanfare, others just – well – worry, stress, and get anxious.

The following tips (extrapolated from NASP “Back to School Transitions: Tips for Parents”) are to help those of you with children who are beginning school soon and tend to get anxious.

  • The first few days may be rough; try not to overreact. Particularly the younger student may suffer separation anxiety after a summer with parents and loose schedules. School personnel are trained to deal with children who may have a hard time adjusting.  Best advice:  Drop off your child without lingering, say “I love you and will be back at the end of the day,” then leave.
  • Talk to your child and let them know that you care. Model optimism and confidence and reinforce your belief in their ability to cope. Tell them that it’s o.k. to be nervous about starting something new, but he/she will be fine once they become more familiar with their new surroundings. Best advice:  Send positive, short notes in their lunch box or backpack and listen to any concerns when they arrive home. Reinforce positives as they discuss their school day.
  • Try to remain calm and positive about any bad experiences from the previous year. Those who had a difficult school year may have more anxiety about their return to school. Children who were teased or bullied, those encountering academic problems or any other difficulties may be reluctant to start another year with a positive attitude. Best advice: Talk to school personnel before school begins about this and then reassure your child that this is a new year and a fresh start. Reinforce that you will be working with the school to ensure a smooth school year and prevention of further issues.
  • Give your child strategies to cope if they are feeling anxious. Be open with the school and keep open communication with your child’s teachers. Encourage your child to tell you or the teacher if problems continue.  Best advice: Maintain open communication with your child and your child’s teacher.
  • Try to allow your child to meet with other students and school friends before the first day to ease your child into the new academic year. Best advice: Encourage your older child to contact friends, or if your child is younger, call the parents yourself to schedule play dates.
  • Plan to volunteer in your child’s classroom periodically throughout the year. This reinforces to your child that you are interested in their learning and that school and family are communicating. Additionally, you are building relationships with teachers, classmates, and other school personnel, as well as learning about classroom routines and atmosphere. Best advice: Even if you can’t regularly volunteer, periodic parent help is often welcomed and only benefits your child.

If your child’s anxiety becomes problematic, extreme in nature, or lasts for an extended period, make an appointment to speak with the teacher or school psychologist. More in-school support may be indicated or other resources in the school or community may be suggested. Remember: most children are very resilient and with support, encouragement, and communication will be able to have a successful school year.

Leave me a comment if you liked this entry.  I’d love to hear from you!  Any suggestions for future entries?  Let me know.

Teenagers and Being Mindful: A Contradiction?

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Hi again.  I’ve been on a blog hiatus, but happily, I’m baaaaaaack!  Hope your summer is continuing to be relaxing and enjoyable.

If you haven’t noticed, I see many children and adolescents in my private practice. I also see many of their parents or speak to them on the phone. I’ve also worked in public schools for 30 years and have had contact with my share of young people, teachers, and parents. Perhaps the most troubling aspect of this age group for teachers and parents is understanding their pre-teens and teenagers.

What is it about this population that is so puzzling? Perhaps it is their tendency toward moodiness. Or….. the constant challenging of your authority? Throw in their past adorable-ness and how they soooo needed you, but now want only to avoid your very presence. Sometimes there is the mix of  “I need you” and then, “I don’t need you,” all in the course of half an hour! Absolutely, I’m sure there are “perfect” teens out there (I haven’t seen one, but perhaps you have), but inevitably most experience changes at this juncture, including social, academic, hormonal, and emotional. A mindfulness practice can help.

What is mindfulness? It is the deliberate practice of paying attention to whatever you are doing, right now.  It is learning to be aware, or mindful, during difficult times in life. We become aware of our thoughts, feelings, behaviors, and physiological changes. We don’t try to change things; just become aware, fully focused. Breathing in and out helps us to stay in touch with this moment. Mindfulness requires practice on a consistent basis.  Perhaps parent and teen can learn this together!

That is exactly why I have become very interested in Mindfulness for teenagers. Recent research published in the British Journal of Psychiatry (June, 2013) revealed that mindfulness could reduce stress and lessen symptoms of depression among high school age students and increase their well-being.

Uh oh—another study. Just what we need!!!  But I liked this one A-Lot. The Universities of Exeter and Cambridge in England enrolled 522 students between the ages of 12 and 16 during their summer exam period. 256 of the students completed a 9-week introductory mindfulness course; the others did not participate in that specific training. It was found that the ones who completed the course reported lower stress levels, less depression, and overall greater well-being.

Over the nine weeks, the students enrolled in the mindfulness course learned a different mindfulness skill each week including: recognizing worry, harnessing the power of attention, dealing with unpleasant feelings, and distancing from thoughts and emotions.

One of the interesting findings was that mindfulness training can help with the psychological well being of all students, not just those who have symptoms associated with mental health problems.  Mindfulness practiced by adults has been more widely researched and has shown to have the effects of lowering stress levels, enhancing sleep, increasing compassion and self-knowledge, and other health benefits. Fewer studies have focused solely on children and adolescents.

I believe a large part of teenage “angst” can be approached with mindfulness techniques.  I have incorporated them into my therapy practice, even with some of the children I see.  The practice of breathing, being in the here and now, focusing, attending, and learning are all part of teaching children and teens to be okay with themselves, become grounded, and self-aware. Not bad stuff to learn on the road to a healthy life.

If you have any questions about mindfulness or any other topic, please contact me.  I am always eager to respond to any inquiries!  Happy day and BREATHE.

ADHD–Part II

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ADHD, as stated in my last post, is one of the most common chronic health conditions for children.  Those with this condition have difficulty regulating their behaviors, attention, and/or impulsivity.  ADHD presents itself in school, home, and the community and can present challenges in each environment.

ASSESSMENT

A comprehensive assessment involving multiple methods conducted by multiple professionals within different settings is important for arriving at a diagnosis of this disorder. Too often the diagnosis of ADHD is made too quickly or by observation alone.  The assessment should consist of communication with the child’s medical professional, and other sources, including a psychologist, educational personnel, and family. A direct assessment of the child is also recommended. The assessment should address the age of onset of the symptoms, the degree that it impairs the child, and any other features.

How do we obtain information from different sources?  First, I believe a good history is essential, one involving the child’s health, family background, and when the child’s developmental milestones were reached. A thorough history is also ascertained from information provided by school records, the child’s physician, and family members, as well as any others who might be familiar with the child.

Secondly, a physical evaluation is essential (and oftentimes, a neurological evaluation is also indicated) to rule out other causes of the disorder.

Next, information obtained from family should address different settings and include ADHD parent and child rating scales or checklists, including the assessment of inattention, hyperactivity, and impulsivity. The family assessment should also include structured and unstructured interviews.

School/classroom assessments are teacher-reported and can provide information including teacher rating scales and checklists of inattention, hyperactivity, and impulsivity, teacher narratives and reports, schoolwork, grades, and work samples, as well as specific data regarding the child’s behaviors in the classroom.

Finally, an assessment of coexisting conditions should take place that rule in or out other disorders that may include depression, learning disabilities, and anxiety, to name a few.

TREATMENT

There is no cure for ADHD at this time, but many treatments exist which are effective in the management of the disorder. When speaking of any treatment, most important is the education of the family and school staff about the nature of the disorder and its management for children. But among all of the treatments available, which ones are most effective?

The treatment that results in the greatest degree of improvement in the symptoms of ADHD is stimulant and nonstimulant medications.  Before medications are considered, though, academic and behavioral interventions and accommodations should be implemented for a reasonable time. Sometimes these interventions are effective alone.  According to the American Academy of Pediatrics (AAP), 80 percent of the children who use stimulant medications, either alone or with behavior therapy, show increased focus and decreased impulsivity. The most common stimulant medication, Ritalin, has been used for over 40 years in children and has shown to be safe. Strattera is a nonstimulant medication that is frequently used with children, as well. Antidepressants seem to be less effective, but are often used with those who have coexisting symptoms of mood disorders.  Some children may need a combination of medications depending on if they have other disorders along with their ADHD. There are side effects to these medications and they should be discussed with the physician who is in charge of prescribing them.

The decision to use medications can be a difficult one for parents, and rightly so!  If you do decide to try medication for your child’s ADHD, there must be close monitoring and frequent reassessment to decide if the treatment is working. Each decision about whether to try or not try medication should be based on what is best for the child as an individual.  There is a great deal of information available on the pros and cons of starting your child on ADHD medications.

Psychological treatments, such as behavior modification in school, social skills training, and parent training in child behavior management techniques have shown to have short- term effects.  Some studies suggest that once treatments end, so do the gains obtained (as with medication treatment, as well). Therefore, ADHD should be seen as a chronic condition that requires ongoing treatment for good, long-term management of the symptoms. Counseling can help parents and children understand the disorder, improve social skills, assist with behavioral interventions, and help those who are having difficulty coping.

Some children with ADHD may be eligible for special education services in the public schools under the Individual with Disabilities in Education Act – IDEA- and/or Section 504 of the Rehabilitation Act of 1973. To qualify for these services, the symptoms of the ADHD must be interfering with the child’s ability to learn in school. Thus, the comprehensive evaluation is important to ascertain whether the school services are warranted.

In summary, the treatment of ADHD requires a comprehensive behavioral, psychological, educational, and sometimes medical evaluation, along with the education of family members as to what this disorder is and the methods proven to assist with its management. Once the ADHD condition is managed, those with this disorder can usually lead adjusted and productive lives.

Please feel free to comment about this topic.  I welcome your feedback!

Time-Out! Make the Most of this Behavior Change Strategy-Part 2

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Last week’s post focused on an introduction to the use of time-out. I emphasized the fact that your child must have the skill set to meet adult expectations before you consider using time-out. I also discussed defining appropriate behaviors for time-out, assigning time out areas (location) at home and at school, and preparing for the use of time-out at home. This week I will focus on the actual steps of implementing an effective time-out procedure.

When you are ready to implement a time-out, your child should be told quickly what behavior earned the time-out and what behaviors are required to end the time-out. Remember these important points: it is recommended that you NOT engage your child in a long dissertation about his/her behavior, and there should be NO negotiating, begging, or arguing, as that will only reinforce the inappropriate behaviors.

After you’ve identified the behavior and calmly stated why he/she is going to time-out, remove your child to your specific time-out area for brief and pre-determined periods of time.  A time-out should last no longer than 1 to 2 minutes for each year of the child’s age. For example, an 8-year-old will be in time-out for 8 minutes, a 2-year-old, 2 minutes, etc.  A child in time-out should be supervised for the entire period, with attention focused away from the child. Do not converse, engage, or play with your child.

When time-out is over, I like to use an audible signal to indicate that the child may come out of time-out. A kitchen timer, oven timer, microwave timer, or audible wristwatch may be used to signal that time-out has ended. In this way, the child learns to NOT leave time out until he hears the signal. (On many occasions, it will remind the adult, as well!).

The child may come out of time-out ONLY if their behavior is appropriate, i.e. sitting quietly for the final 30 seconds to 1 minute of the time-out. If you release your child from time-out during a tantrum, while screaming, or being disruptive, your child learns to express these behaviors to end the time-out. If your child refuses to leave time-out, ignore him/her. Do not engage in arguments at this time as it can lead to noncompliance with the time-out process.

When your child leaves time-out, he/she must complete the task or request that occurred just prior to the targeted behaviors. Allowing a child to use time-out to avoid a task or situation is counterproductive. For example, your 10-year-old spilled a glass of juice on the floor, resulting in a tantrum and refusal to clean the spill upon your request. After the 10 minutes in time-out, he/she will be required to clean up the spillage – not you.

When time-out occurs in a school situation, it should be shared with all staff involved with the child. How long the time-out lasted, the child’s behavior while in time-out and the behavior directly preceding or leading to the time-out should be documented and posted in entry/exit of the time-out location for other staff members.

Written documentation can reveal important data about your child and his/her behavior and the effectiveness of the time-out. It is imperative if your child is in time-out in school that proper documentation is recorded for every occurrence. However, I personally do not believe that documentation at home is as important as at school UNLESS your child’s behavior has become so problematic that documenting it would help other caregivers. In all situations, if the behaviors do not decrease after two weeks, then reevaluate the procedure, with one important exception—If the behaviors are dangerous, it is recommended that you not wait two weeks before seeking the help of a professional.

Of course, time-out does have limitations to consider. When in time-out, the child is removed from positive learning and/or social situations. For children with limited social skills, this is particularly concerning. Some children LIKE being alone and time-out is too reinforcing for them. Time-out can also be reinforcing to adults as it removes the difficult child, which can entice the adult to use time-out too frequently, for longer periods of time than recommended, or for other than targeted behaviors. That is why keeping a written log and reviewing it daily or weekly can be so important. If the log indicates that the procedure is not working, then the program may be tweaked to make it more effective.

Time-out is a very effective procedure for behavior change if used properly, with good planning, documentation, and review. I would love to hear your experiences with time-out with your children or students.  Please leave me a reply with your comments, suggestions, or possible future topics.

Time-Out! Make the Most of this Behavior Change Strategy

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As a follow up to my last post on temper tantrums, I wanted to focus this week on one of my favorite behavior change strategies—time-out. Time-out is often used incorrectly, so I’d like to provide some practical and useful tips and advice on the proper use of time-out.

Time-out is actually shortened from the phrase time-out from positive reinforcement.  In other words, you are removing a child from the opportunity to earn reinforcement when a specified misbehavior occurs. This reinforcement may be a treat, a preferred task or activity, attention from parent or teacher, a TV show, etc.

To implement a time-out approach, you must first identify the behavior(s) that are appropriate for time-out. Also, the child must have the skills to be able to comply with your demands. For example, if you ask your two-year-old child to clean her room, she probably doesn’t have the skill set to complete such a task, it might not be safe for her to complete the task alone, and developmentally she probably isn’t ready for such a multistep, complicated process. However, if she’s able to pick up her three stuffed animals and place them in her toy chest, then she has mastered ONE component of cleaning her room. It is NOT appropriate to punish a child for noncompliance when she does not have the skills to comply with your demands.

What’s an appropriate time-out location? Appropriate time out areas should be clean, safe, boring and in view of an adult supervisor. The area should not be frightening, threatening, nor provide access to TV’s, video games, music, or other enjoyable tasks. Time-out will not be successful if the designated location is a better place than the environment the child was in.  In other words, it is important to provide the child’s home or classroom with a high rate of positive reinforcement when the child is engaged in appropriate behaviors. The time-out area should be inside the home such as in a designated chair, bottom of a staircase, or the bathroom.  In a classroom, time-out is in a designated chair or a seat in another classroom, but never in unsupervised areas or in an unsupervised hallway.

When implementing time-out at home, preparation is a must. Consider the following:

  • Define appropriate behaviors for time-out, those which are measurable, observable, clearly stated, and known to the child.
  • A simple, written plan describing the procedure for time-out should be available to all caregivers in the home (i.e., babysitters, day care, etc.) and followed by all by agreement.
  • Rules should be followed as related to the target behaviors. These rules should be stated positively, observable, have been pre-taught, reviewed and re-reviewed regularly. Consider posting basic rules, as well.
  • Make sure that the child’s tasks are within his/her skill level.
  • Time-out areas in the home should always be monitored by an adult, be nonreinforcing for the child, and be realistic and appropriate.
  • Pre-teach your child about your time-out procedures, like a role-play situation, and before the child misbehaves for the first time. Have your child practice time-out steps, be able to state the behaviors that will initiate a time-out, and understand the expectations surrounding time-out. If the child is well practiced, it will be easier to get to time-out when he/she really needs it!
  • Do not reteach time-out procedures or explain procedures during an actual time-out. If further teaching is required, provide more role-play situations in a calm period.

How do I implement effective time-out procedures in my home, or away from my home?  I will answer this question and provide more time-out information in next week’s post. Let me know what you think, or if you have any questions regarding time-out, please feel free to post them here and I will respond to your inquiries.