Judith Warner, author and columnist on parenting issues, has just published We’ve Got Issues: Children and Parents In The Age of Medication. She began her project with the commonly held mindset that children are over-medicated through a collusion between parents, who want their childrens’ behavior to change, and psychiatrists, who are more than happy to whip out the prescription pad.  What Warner discovered, and what our experience at Soho Parenting has been over the last two decades, is actually the opposite. Parents go through excruciating conflict, ambivalence and worry about using medication with their children who are suffering from a psychiatric or neuro- biological illness.

Contrary to the “over-medication” hype, parents often have a hard time accepting that their child’s symptoms are an indication of a serious departure from typical development. When a children have depression, bipolar disorder, ADHD, or autistic spectrum disorder it is unbearably painful to accept. Decisions to use medicine to treat, or ameliorate symptoms is a huge choice.  The known risk of leaving these problems untreated sometimes feels less risky than taking medicine. This is often the wrong call.

In our clinical practice, we have seen a rise of developmental delays as well as a rise in mood disorders, behavioral and emotional struggles in children. The causes are most likely multi-determined. The impact of toxins in our food supply and environment, the unhealthy pressured culture our children must conform to, and the marriage of genetics in parents who also may struggle with significant levels of anxiety and depression all lead to more vulnerable systems in our children.

Having this awareness allows parents to make healthier choices about their lifestyles and practice preventative care.  Acknowledgment that your child struggles with mood or reactivity issues is necessary to fight stigma, advocate for kids and to counter the feelings of failure that parents and children alike experience if these issues arise. Treating such childhood problems with effective therapies, and yes, many times, with medicine, can be the difference between utter suffering and a calmer, more productive and functional experience for affected children, their siblings and parents.

In almost 25 years we have met only one family that seemed blithe about using medicine to maintain a child’s enrollment in a high pressured and “prestigious” school.  All other parents have approached the diagnosis, starting therapy, and possibly medicating their children as a truly serious decision–usually leaning toward under-treating. The stories of children being helped by a combination of therapy and medicine abound. The relief and hopefulness is always tempered by worry over the long-term effects, but children who need medicine and receive the correct medicine are freed from a dark place. Kudos to Warner for her open-minded research, her hard work on the book, and her contribution to parents –to help them make the best choices for their children and their families.

The New York Times article, For Some Parents Shouting is the New Spanking, by Hillary Stout,  bravely shines the light on a slightly taboo topic. In many parenting circles, spanking is a discipline tool of the past.Whether or not parents actually resort to spanking is another story.

When it comes to screaming, however, it often seems accepted as a matter of course. Everyone  has a reflexive, knee jerk stance based on family of origin. If you came from a family of screamers, yelling might feel completely normal. Many people feel it is an ethnic rite or genetically encoded behavior. Others remember their parents yelling and screaming and the fear that it engendered. These parents do a yeoman’s job of controlling their tempers, but nevertheless find themselves overtaken by fury and frustration at times. Some grew up with simmering issues but no communication, so “letting it all out” can feel like a healthier way.

The problem is that yelling and screaming can feel so damn good while you are doing it. You feel powerful, like you are someone to be reckoned with, self-righteous and entitled.  After all, what human being can cope with the amount of badgering, whining, and defiance that kids dish out. In actuality, the desire to yell actually comes from the opposite place: a place of helplessness, feeling overburdened and incompetent. Screaming and yelling bring false empowerment. True power is when parents control themselves, for example, putting their child in their room without yelling or ranting or being able to take away privileges in a three word sentence like “No TV tomorrow!!”

Unfortunately, the nature of children and the culture we live in has the deck stacked against parents. Kids need repeated reminders, often years of reminders to do things like saying please and thank you, coming to the dinner table and not smashing their siblings. Our culture is all about getting what you want by taking no prisoners.  Given those forces, staying respectful calls for a kind of determination, focus and self control that seems only a zen master could muster. The good news is that self control can be learned. Start with this rule. Screaming, name calling, ranting and shaming is NOT ALLOWED. It is a boundary violation and something to avoid. Remember, it is not our right as a parent.

Since most people are not zen masters, realistically you probabaly will yell or scream when you are in your most helpless and overwhelmed state. Treat it as if you had hit your child. After you calm down, apologize. Remind them that it wasn’t OK, and that you are really focused on learning to control that behavior, just like they are.

A recent article on the effects of switching the order of recess and lunch by Tara Parker Pope makes great sense. Moving recess earlier and lunch afterwards affected both kids well being at school and also resulted in the waste of food. At a time when some schools decrease recess time to fit in more academics, it is another reminder of how important play time is for children. Pediatrics reports that a new study confirms the idea that having recess versus not isn’t in the best interest of a child’s academic performance. Parents must protect the needs of children by remembering that old fashioned running around and climbing the monkey bars is an important part of a school day.

The dreaded “D” word.  Parents worry so much about talking to their children about death. We as a culture are so death phobic, we like to pretend it only happens to other people. Ben Franklin said, “In this world nothing can be said to be certain, except death and taxes.” Maybe some people can get out of taxes, but so far no one has escaped eventually dying.

So since it is inevitable, let’s focus on the positive side of what young children can learn when someone close dies. First, they can experience comfort. When a person in the family dies, they observe the coming together to show love and support – with flowers, food or a visit. They can offer and listen to stories and memories and pictures.  What a wonderful lesson to teach – when someone dies, we can get comfort and give comfort and that is profoundly satisfying.  We can teach our children that death can bring people together.

If the person had been sick, children learn that one of our most important jobs is to take care of loved ones when they need us. They will see you model that and will grow up to care of their families and friends as well.

Another opportunity that death brings is the chance to begin a discussion that has been the source of some of the most profound thought – what is the nature of life and what is death. Children are so philosophical and ask the most amazing questions as they grapple with the limits of their level of cognition. This will result in you as an adult beginning to think about these questions as well. Some of you will rest on age old traditions from your religious upbringing and family, some will be at a loss and need to create some new ways of approaching death.

For the people that feel less sure about what happens or do not believe in any afterlife or God, they often feel strongly about not “lying to their children”. Children need stories and fables to understand the world around them, but that does not mean they will continue to believe in that explanation for the rest of their lives. Do you have the same feelings about God or death that you did at 6 or 16 or 26? Most likely you won’t feel the same at 56 or 86 either. If you have to use metaphors or fables to help your children understand loss, know that those ideas will grow and change. So if you talk about heaven as a peaceful place you go when you die or about reincarnation and questions arise such as, “Do you think Grandpa’s next life will be as a squirrel or dog?” do not worry that if this is not your belief you are lying. On the contrary, you are helping a child think about the lasting nature of that person.

Here are some things to say that are clear, simple and honest:

We won’t see Grandpa anymore, but we can think of him and look at pictures of him and tell stories about him.

All things in nature have a life and then they die, like flowers and fish and doggies and people.

Kids will worry about losing you as well, you can reassure them that you are healhty and strong and are there to take care of them. If they ask if you will die one day you should answer yes, but you hope it will be a very long time form now.

Remember that children as young as one or two will recognize and understand on some level that a special person has died. So be conscious of little ears.

Kids snacking and having “treats” throughout the day has exploded in the last decade. The article  Snack Time Never Ends in the The New York Times, January 20, 2010 presents data that, “between 1977 and 2002, the percent of the American population eating three or more snacks a day increased to 42 percent from 11 percent.”

From 2002 to 2008, one needs only to look around the playground to know that the trend has increased. Food is ubiquitous and adults and children are presented with constant eating opportunities. Add in the generational fear and antipathy to saying no to one’s children and you’ve got haggling and caving going on all day long!

Ellyn Slatter, dietitian and family therapist, is quoted in the article, “The parents’ job is to do the what, when and where of feeding,” she said, “and it is up to the children to do the how much and whether of eating. In order to have successful family meals, you have to structure the snacks.” Her book, Child of Mine: Feeding with Love and Good Sense, has long been one of Soho Parenting’s favorites.

Here are a few tips to curb snacking and unhealthy eating:

• Snacks should be given at “Snack Time”: A scheduled time and place and not on the run. As Slatter wisely says “End grazing.”
• A good snack is anything you would be happy to see on a child’s plate at a meal. Goldfish on the dinner plate? Fruit Roll up for breakfast? No?
• No more than 2 snacks a day.
• A snack and a treat are two different things. Treats are desserts, snacks are tiny meals.
• Keep “treats” treats by offering them less often.

Many of the families we have worked with lived through 9/11 and therefore don’t have to start from scratch when it comes to explaining this frightening event. They have a framework to discuss terrorism in general, and this failed terrorist attack in particular. Those children already know the cold hard fact that bad things don’t just happen in remote places-things happen in America as well.

Parents with children who were born more recently have a new and difficult task added to their job description; talking to kids about terrorism. The first most important thing to remember is that it is almost impossible to shield children from hearing about it. If they have not already seen it on the news, heard grownups talk, or read headlines and pictures on the newspapers, then the first day back at school will change all that.

Parents are often surprised to learn that children as young as three and four years old will inevitably be exposed to some aspect of this news story.  Best for you to be their main source of information and reassurance rather than hearing bits and pieces or distortions of the truth when they are not with you. Look for an opening in their play. They could be crashing cars and “killing” someone, they could be drawing a picture of a plane. Or watch your child for symptoms of anxiety–nail biting, more agression than usual, worry about being alone.  It could start out as simple and straightforward for young children (3-6 years) as, “A bad man tried to hurt a plane and the people on it, but all the people jumped on him and the plane and all the people are safe. The man is in jail.” Talking with tweens and teenagers about the Taliban, suicide bombers and wars in Afghanistan and Iraq will be more complicated.

Then be prepared for questions. For all children their first worries will be about themselves and their own family’s immediate safety.  Just like with 9/11, it will be important to focus on the heroic measures that real people took in combating the violence.  This is when you say, “All the police, and fire fighters and soldiers and President Obama are working very hard to make sure this does not happen again.” If you are actually flying in the next few days and your children are nervous (or you are!) point out all the security measures at the airport to check for dangerous materials or people on the plane. Try to keep a calm and positive demeanor.

No matter what your particular political beliefs are, this is not the time to undermine your child’s sense of confidence in our country’s leadership.   What you can tell them is that hurting people is wrong and that this man was caught and put in jail. That is reassuring to children. What is  not reassuring to your children is venting your own anger at either jihadists, or the incompetence of our own government.

The hard thing is that this terrorist attempt, bungled as it was, really reminds us that this violence is very likely to become more common here. The safety we felt as kids, at least about war here on our own soil, is over. We do have to remember that most children in the world live with fear and violence as an everyday reality.  We can help our children tolerate their fear if we make sure we are not in denial about how much they know and help them make sense of this frightening reality.

The American Psychological Association has released its Stress in America 2009 report.  We all know there has been more stress in the last year, but there was a troubling finding in the study. It seems that there is a significant disconnect between parents perception of their children’s stress and their children’s actual experience. Here are a few examples from the report:

•Children were nearly two times more likely to say they worried about their family’s financial difficulties than their parents perceived (30 percent of youth say they worried about their family having enough money when only 18 percent of parents reported that this was a source of stress for their child.

•Children were more likely to report that they worry about things related to school than parents perceived. Forty-four percent of all children ages 8 – 17 reported that doing well in school was a source of worry compared to only 34 percent of parents reporting this as a source of stress for their child. Over a quarter (29 percent) of children ages 13 – 17 reported that they worry about getting into a good college and deciding what to do after high school, when only 5 percent of parents of 13 – 17-year-olds agreed that this was a source of stress for their child.

•Nearly half (45 percent) of teens ages 13-17 said that they worried more this year, but only 28 percent of parents think their teen’s stress increased, and while a quarter (26 percent) of tweens ages 8-12 said they worried more this year, only 17 percent of parents believed their tween’s stress had risen.

“Nearly a quarter of Americans reported experiencing high stress levels in the past month (8, 9 or 10 on a 10-point scale), yet, many parents seem unaware of the impact that their stress has on their children. Nearly two-thirds (63 percent) of parents reported that their stress levels have a slight or no impact on their child’s stress levels, which is concerning when considering the number of young people who view their parents as their primary teachers as it relates to learning about healthy habits. Nearly 80 percent of young people say they learn about healthy living from their parents or guardians, suggesting that parents are important role models for children. Yet parents are not modeling healthy behavior when it comes to stress management. Half of parents (50 percent) say their stress has increased in the past year, but less than half of moms (45 percent) and just over half of dads (56 percent) say they’re doing enough to manage their stress.”

Even now, in the 21st century, the idea that children don’t really understand what is going on in their immediate world persists.  And it is such a stressful century so far.  Children have a deep emotional world with a wide variety of feelings including anxiety.  They are completely aware of the ups and downs experienced by the adults in their life. By denying this, parents limit their capacity and opportunity  to soothe, reassure and show them how to tolerate stress.  So the next time you think, “I don’t think it’s affecting the kids.” Think again.

The recession has been good for the holidays. This is the second year that the ethos of the holidays consists of getting less, spending less and really tuning into what the deeper messages about the seasons mean. Most parents who toned down the consumer frenzy last year were much more content with their holiday celebrations. Less stories about over stimulated kids ripping through mountains of presents and then demanding more. Less stress in preparing for the holidays.

What people remember most about their holidays as kids are the lights, whether Christmas or Chanukah, the scents of pine or baking or potatoes frying and the wonderful assortment of tastes. Who really remebers what year you got your bike, or a doll, or board games or gameboy? It is wrapping paper and ribbons and rituals we remember. So, when planning your holidays focus on the senses and not on the gifts. Pass on traditions or invent new ones. Those are the memories in the making.

Parents often ask about age appropriate ways to volunteer or do charity work with their children. This holiday season hunger is at our doorstep. Our country is facing record levels of hunger, and the use of food stamps is climbing each month. Each crisis provides an opportunity for teaching kindness and spiritual growth.

A simple act of charity is a wonderful way to give your child the chance to help out. Locate the nearest shelter or food pantry. Find out if they accept donations of food and whether it can be canned, boxed or fresh. Then take your children to collect items in your building or neighborhood and bring it to your destination. Explain it to your children by relating it to trick or treating. This time you are collecting food for others and not candy for yourselves, but it is essentially the same process! Have a conversation with them, discuss that some people do not have enough food in your town. Reassure them if they get worried that you have more food than you need.  You can go with a group of kids and parents and make it something infused with camaraderie.

PS. A big thank you to all families who participated in Soho Parenting’s “Give a Good Hot Shower” bath products drive for Safe Horizons! They were so happy to accept our donations.

Over-parenting has made it to the cover of Time Magazine! An easy read, the article outlines how an over-investment in childrens’ “success” coupled with exaggerated worries about safety has lead to an odd combination of pressure and coddling.

What is really fascinating is that at the same time the American Psychological Association has released Stress in America 2009,  showing that parents are very out of touch with their children’s anxiety. Distracted by the focus on achievement and sheltering children from pain, parents are missing the point.  Children are capable of more independence and very much need our emotional support for their inner lives.

Since no parent wants to be unaware of their child’s emotional life this is a great wake up call. A reorienting of our values toward the inner life rather than the outer trappings will help children feel a real sense of protection and support.