Everything that parents are experiencing, kids are too. Kids are affected by the stress that their parents have in their lives. Whether it is the mild frustration of being cooped up too many days in a row, or the panic of not knowing where the money for food and rent is going to come from, children are affected by what their parents say and what their parents don’t say, as early as before they are even born.
The most at risk children, who get many of their meals from school and who depend on their teachers to notice when something is really wrong, are now at home full time with few resources and in some cases, their abusers.
Children with disabilities are also more at risk right now. Children with accommodations and services at school—speech, behavioral therapy, structured interventions—they will be likely to regress without these services being available at home on a regular basis.
It’s too soon to know the extent of many problems that will occur. Kids who struggle with mood disorders like anxiety or depression may improve or get worse, depending on how safe and supported they feel at home. Older children and teenagers who are at a point where their peers are most important to their social life will likely struggle the most with this. And it will get worse the longer it goes on. With education, the spring’s quick move to online learning was a mess for many school systems—it’s unclear whether more time to plan will be better for students and help them get the information they would typically be learning in a normal classroom environment. And to be clear, when we talk about distance learning, we are not comparing distance learning to just regular schooling as normal, because even sending students to school right now is very different than it was 8 months ago. Wearing masks, maintaining 6 foot distances from one another, worrying about germs, there is no normal option right now. We all hope that it will be better this fall, but this is new, uncharted territory. What is ironic with all of this is that the answer seems to be the internet—that which we have worried so much about is now a safe way that children and adolescents can connect with peers and teachers and feel less isolated.
And finally, the direct impact of Covid. Some kids will get sick—some kids will get really, really sick. And some kids may not get so sick, but may bring that illness home to their loved ones, and they may get very sick or die. These kids will experience trauma, and it will be significant. We don’t know how many or who it will affect, but it will touch many families, and it is heartbreaking.
I wish I had answers for how to improve this. There are no easy answers. But I do have some ideas and suggestions for those of you who feel called to help.
If you have children and families in your life, I encourage you to connect with them in any way you can—bring a friend or mentor to a child, or a struggling parent can mean the world to someone. Interacting with a child on the phone or over a zoom call can provide them opportunities to take turns, negotiate, and practice some social skills, all of which would be beneficial to them.
I do feel that this is a great opportunity for churches and other community organizations right now to connect with children and families. This is a time when many of the things that families do—sports, activities, travel… are either not taking place or are much different. Providing children and families with a sense of security and regularity can help add some positivity to the week.
Finally, just practicing kindness and non-judgment of others. Nobody fully understands the struggle that anyone of us is going through right now. It’s easy to have some negative thoughts about someone’s Facebook post, political position, or perceived action right now from where you are sitting. We will go much farther working together than we will by tearing one another down. Bite your tongue when you have to, and go out of your way to be kind and supportive when you can.
This is a challenging time for everyone right now—be safe, and take care of yourself and each other.
Screens are everywhere—technology has changed our lives, and it is having new and unpredictable impacts on our children.
Infants and young children learn by observing and interacting with their environment. They smile, you smile. They coo or say a word, you talk back to them. They drop a toy and you pick it up again, and again, and again…. Screens are not responsive to children in the way that people and some other objects in the environment are. Whether it is a ball that rolls off the table or a parent imitating the child’s gestures in a back and forth manner, it is important for children to be learning rules about how the world works and learning to make sense of their environment. Being over-involved in screens takes time away from these activities and children miss out on learning opportunities.
In a similar way, young children learn many social skills early in their life, and social interactions build upon each other. Babies learn early on how to elicit reactions from people—by smiling, making eye contact, and imitating the actions of others. When they engage in these behaviors, the world becomes friendlier, more predictable, and an exciting place to explore. What happens when they smile at an ipad? Nothing. Children who are spending a lot of time using screens are losing out on opportunities to acquire these social skills, or are not having as many opportunities to practice these social skills, which leads these areas to be underdeveloped.
Additionally, children learn from an early age a balance of patience versus instant gratification. Screens provide constant instant gratification, with the lights, colors, and often fact-paced action. Many apps and games have a variable style of reinforcement, which, similar to slot machines in a casino, is extremely addictive. Patience is not an innate ability but an acquired skill that takes practice, and children who get constant instant gratification do not have opportunities to learn patience, potentially resulting in behavior problems in other areas. Another skill that is affected by the overuse of entertainment is creativity. Creativity develops when kids are bored. And boredom is something that all of us seem to be experiencing less and less of—when you have a phone in your pocket, or you can cue up whatever show you want on tv without having to wait through any commercials, the idea of waiting and downtime becomes almost intolerable for many.
There has been some research on how screen time affects young children, but all of this is correlational. Scientists are not able to randomly assign children to either watch a bunch of TVs or not, so it can be difficult to know what is a direct result of screen time versus a risk factor that may actually lead to more screen time. Regardless of what comes first, studies have shown excessive TV viewing is linked to the inability to pay attention and think clearly poor eating habits, and behavioral problems. Higher amounts of screen time are also associated with language delays, poor sleep, impaired executive function, and a decrease in parent-child engagement.
I think what is extra tricky about screen time is that it seems like it works so well for kids, including those with behavior problems and attention problems. It’s almost like magic. Rather than arguing or whining or throwing a tantrum, they are just sitting quietly and not causing any problems. I know you have all see those families in restaurants where kids are each on their own device and honestly, sometimes the parents are too, and no one is even acknowledging each other. The problem is that for kids who are extra difficult, whether they have learning or attention or behavior difficulties, it can be a very slippery slope to more and more screen time because the kids and the parents both know what will happen when the parent says time to put it away, and they don’t want to deal with the consequence. And so these most vulnerable kids, who arguably need the MOST attention and one on one support, are sometimes getting some of the least.
A study in 2019 scanned the brains of children 3 to 5 years old and found those who used screens more than the recommended one hour a day without parental involvement had lower levels of development in the brain’s white matter — an area key to the development of language, literacy, and cognitive skills.
As kids get older, it gets more complicated. Rather than videos and play-based apps, pre-teens and teenagers spend more and more time on social media, where popularity and social connections are out there for everyone to see. Social media can be like a drug, where both kids and adults strive to get posts for more and more likes, or they can be evidence of being left out in a way that was never so visible and obvious before. I don’t know about you, but I am glad I didn’t grow up with social media. And I’m already worrying about how it’s going to affect my daughters. It’s one thing to find out on Monday that you didn’t get invited to a party that took place over the weekend. It’s quite another to see picture after picture uploaded on Facebook or Instagram, or whatever is the newest, hottest thing at the moment that you are being excluded. Bullying can take place in both subtle and overt ways, and what is especially problematic is that the bullies don’t even see the impact of their actions in a way that may lead to any change. Part of developing empathy is seeing how people react to our actions. When people can say whatever they want without any view of how that impacts their target, they may say even more the next time.
Suicide is the second leading cause of death among teenagers in the United States, according to the Centers for Disease Control and Prevention. A CDC study found that teen suicide jumped 56% from 2007 to 2017. Many family members of teens lost to suicide talk about the impact social media had on their loved ones. It’s not all just bullying either. Part of the danger of the internet is that you can find whatever you are looking for—whether the perfect recipe for mashed potatoes, how to change the oil on your car or, on a more negative side, how to fool your family into believing you don’t have an eating disorder or how to complete a successful suicide. As adults, we—most of us—have the sense to think critically about what we are learning, and not follow a rabbit hole that will lead to things we do not want to know. But teenagers are still learning and maturing, and sometimes they can have a very difficult time seeing past the struggles they are feeling at a particular moment.
All this being said, there are lots of negative aspects to screen time and social media, but there are also lots of great positives. There are wonderful groups and communities where people can support one another and find connections that may not be available locally. It’s just like any other ‘new technology’ we as humans have developed over time—fire, automobiles, electricity—all have the capacity to help us tremendously but also the ability to destroy us if used inappropriately.
Knowing all of this, we are working against teams of people who are researching exactly how to keep kids as engaged for as long as they possibly can. These are very smart people with lots of resources, and they are good at what they do. And it’s not just what we tell our kids—it’s also what we are showing them—since kids learn even more from what they observe than from what we tell them.
None of us is perfect. But I implore you to think about how you use technology in your home, not only what the rules for your children are, but what rules you have for yourself. There are tremendous opportunities with the internet, but also significant risks. If you don’t choose your boundaries, someone else will, and they will not necessarily have your best interest at heart.
When you are raising a child, it can be difficult to know what is normal and what is not. It can be a very fuzzy line, and many unusual behaviors can come and go quickly. Is there a length of time for when to be concerned? Or is it more related to the severity of a behavior?
One of the best indicators of when to seek help is if you feel in your gut that something may be wrong. Even if you can’t pinpoint exactly what it is that is making you uncomfortable, seeing your child alongside peers or by comparing their behavior to how their siblings may have developed can give you an idea of what is typical versus what is atypical.
Sometimes teachers or other family members may recognize concerning behaviors and bring that up with you. This can understandably be hurtful and difficult to hear, but if you trust the person who brings it up to you, it may be worth paying attention to. You might not choose to act right away, but sometimes it is difficult to recognize what we aren’t familiar with. Recognize that it may have taken some courage for that individual to speak up and say something, so they may have something important to say.
All children are different, but if you find that you have to significantly adjust your own behavior to avoid potential meltdowns, that may be a reason to get help. I’m not talking about avoiding outings during naptime or those types of changes, but if your child will only eat one very specific type of food and you are driving through Wendy’s drive-through on a daily basis, or you find yourself tiptoeing around the house to avoid placing any demands on your child, dealing with those issues sooner can help your child learn to be more adaptable (and in turn, make your life much easier!)
I do Parent-Child Interaction Therapy with children and their parents, a behavioral parent-coaching model that helps parents improve the parent-child relationship, establish consistent, effective discipline, and helps young children learn to deal with strong emotions. Working with a specialist who understands young children can help parents understand what their children need from them, and guide them toward services that can help.
How should you choose a psychologist?
What makes someone a good doctor or therapist for one person might make them the wrong choice for another person. Psychiatrists, psychologists, and therapists have different backgrounds and specializations. You should seek a provider who specializes in the type of difficulty you are seeking help for. If you are looking for someone to do an autism evaluation, you should choose someone who is experienced with autism. If you are looking for someone to assess a Traumatic Brain Injury (TBI), you should find someone with experience working with TBIs. Providers who specialize in a particular area are more likely to be up to date in the research and evidence-based strategies to help you.
Regardless of what type of treatment you are pursuing, evidence has consistently shown that the relationship a person has with their provider is one of the most important, if not the most important predictors of success. You should be comfortable talking to your provider, being honest, and feel like you are being heard. I have heard too many horror stories of clients who have had previous therapists who were dismissive of their concerns, judged them for their lifestyle or beliefs, or just did not alter their ‘standard format’ to be responsive to clients.
Do some research before you make a decision. Check out the websites of providers you are considering, and see if you can do phone calls or consultations to get any questions answered.
If you think I might be the right fit for you or your child, reach out and email me at firstname.lastname@example.org!
Many children occasionally get into trouble; they do naughty things or act impulsively. This is frequently a rite of passage for many children, and with some learning and some disciplinary consequences from their parents, these behaviors decrease over time. Some children, however, engage in more difficult behavior which creates serious challenges for parenting. This may be indicative of a behavior disorder. For these children, behavioral health may be a part of the solution, because traditional parenting techniques are less effective. Child behavior varies from age to age, situation to situation, and time to time, making it difficult for parents and caretakers to understand children’s behavior and know what is normal and what is a sign of a bigger problem. Seeking behavioral support can help address current behavioral concerns and improve outcomes for the child over their lifetime, since self-esteem, relationships with authority figures, and prosocial behaviors build upon earlier learned skills.
What is a Behavioral Disorder?
Behavioral disorders are disruptive patterns of behaviors among children that occur for at least six months at home, school, or social events. These can significantly impair a child’s functioning and create problems for them in multiple areas of functioning.
Common Childhood Behavioral Problems
Many behaviors of young children can be a problem at times, especially commons areas like:
- Eating problems
- Sleep problems
- Aggression (to self or others)
- Temper tantrums
- Breath-holding spells
- Avoiding school
- Preschool issues and problems
What Are Different Behavioral Disorders?
At times, behavior problems in young children are indicative of other mental health concerns. Sometimes, behavior problems are the first signs of more serious conditions. These disorders include:
- Autism Spectrum Disorder (ASD)
- Attention Deficit Hyperactivity Disorder (ADHD)
- Learning Disorders
- Anxiety Disorder
- Oppositional Defiant Disorder (ODD)
- Conduct Disorders
- Bipolar Disorder
Among the common disorders are the following;
Attention Deficit Hyperactivity Disorder (ADHD)
Almost 2-5% of children have Attention Deficit Hyperactivity Disorder, sometimes called ADD, with a higher ratio of boys than girls. The different types of behavior seen in them are;
- Impulsivity– They act without thinking and jump into situations head-first
- Inattention– They forget instructions, are unable to focus, and leave tasks incomplete.
- Overactivity– Continuous fidgeting and restlessness, like they are driven by a motor.
Children with Conduct Disorders often have difficulty at school or in other settings, because they have a refusal towards following rules.
In the United States, 2-10% of children have a Conduct disorder during their lifetime. These are more frequent in boys than girls, and about one-third of children diagnosed with Conduct Disorder are also diagnosed with Attention Deficit Hyperactivity Disorder.
The symptoms of Conduct disorder include:
- Habitual Lying
- Lack of empathy/No concern about how their behavior impacts others
- Running away from home
- Oppositionality and defiance of authority figures
- Substance abuse in older children
- Use of weapons
- Aggression toward peers
- Aggression towards family and animals
- Criminal behavior, such as breaking things, stealing and lighting fires.
Oppositional Defiant Disorder
About one out of ten children, of age ten years, have Oppositional defiant disorder, and again, boys outnumber girls. Following are the behavior patterns of children who have Oppositional defiant disorder:
- Refusal to obey rules.
- Blaming others for their troubles
- Low self-esteem, frustration control
- Throwing temper tantrums.
- Deliberatelyannoying others.
- Being frequently irritated, annoyed, and angered.
- Difficulties with authority figures
Many risk factors can contribute to the complexity of the following behavioral disorders.
- Family Life– These disorders are more common in families with poor parenting skills, domestic violence, and substance abuse (though not always!)
- Gender– Boys are more commonly diagnosed with behavioral disorders than girls.
- Brain Development– Children with ADHD are more frequently diagnosed with other behavior disorders.
- Intellectual Disabilities– Children with intellectual disabilities are more commonly diagnosed with behavioral disorders.
- Birth and Gestation– Premature birth, low birth weight, difficulty in pregnancy, and delivery can lead to behavioral disorders.
- Learning Difficulties– Problems in reading, learning, and writing contribute to behavioral disorders.
- Temperament– Children with more difficult temperaments are more likely to be diagnosed with behavioral disorders.
Methods of Diagnosis of Behavioral Disorders
There is often a fine line between what is typical and what is problematic, and it can be hard for parents to know what needs to be done to help their child. To make things more complicated. Children with one behavioral disorder may be more likely to have another behavioral diagnosis, and the symptoms of these conditions can overlap and exacerbate one another.
Methods of Diagnosis include:
- Interviews with teachers, parents, and children.
- Behavioral checklists, including questionnaires about behavior.
- Other standardized measures may be included to confirm or rule out other psychological concerns.
- Psychological evaluation by a licensed psychologist, who incorporates various sources of information and compares this information to the diagnostic criteria for different conditions.
Treatment for Behavioral Disorders
Treatment for child behavior problems is essential. As they get older, children with untreated behavioral disorders are more likely to abuse drugs and alcohol, drop out of school, be unemployed, and be incarcerated. The earlier you diagnose and start treatment, the better it will be for your child. A combination of behavioral treatment and medication management for ADHD can significantly improve a child’s behavior in school, home, and social events.
Treatment is different for all disorders, but there are some commonalities.
Some of the techniques for treating children with behavioral disorders are:
- Medication– Address the brain-based differences and decrease aggressive and impulsive behavior.
- Encouragement– Increase the presence of positive behaviors.
- Social training– Enhancing social skills will help improve the behavior of the child.
- Family Therapy– Working together, families can change the dynamics at home.
- Anger Management– Help children to manage anger appropriately.
- Parental Education– Specialized parenting techniques can help parents understand and act in a way that supports their child’s mental health.
- Cognitive Behavioral Therapy– Teaching children ways to manage their thoughts and behaviors.
- Help in relevant problems– If learning difficulties or mood disorders are exacerbating behavior problems, helping children improve their abilities in these areas can address problematic behavior.
Behavioral disorders in children can be challenging for parents and if left untreated, can lead to many negative outcomes. Behaviors may be problematic at home, at school, or in other settings. If your child is struggling and you are concerned about whether their behavior is normal, Dr. Jessica Myszak at the Help and Healing Center can help. She has specialized in psychological evaluations of children for many years. She can help give you direction and provide recommendations for help. Support your child’s future by helping their present needs.