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Children in the Aftermath of Trauma

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Sad child on black background. Portrait depression girlWe try to protect our children from as much as we can, but sometimes life has other plans.

The murders in Orlando have taken over our thoughts, our conversations at home and with friends, the internet, and the television waves. Our children are being bombarded by the nightmare in front of the TV at home, in conversations with friends, and with questions asked by their peers. It can be too much for a child to deal with.

Your child’s experience of an event will vary depending on their age,  personal style,  life experience, and  closeness to the disaster. A toddler will only care that his or her parents seem to be upset. Older children will hurt for the people involved, worry about friends and relatives that are not within their sight, and worry that it could happen to them sometime, at some other event. What seemed exciting to discuss with friends during the day becomes frightening after the lights go off.

Listen to them talk, and be patient when they ask you the same questions over and over. Reassure them, let them know that such things are extremely rare. Answer questions truthfully, at their own developmental level. Never lie.

Monitor what your child sees and hears – adult conversation and the media can magnify fear and confusion and increase their trauma. Repetition can intensify anxiety; pictures can get locked in their heads.

After the event symptoms of post-traumatic stress may appear, even in children not directly involved. They may be sad or moody, easily angered or irritable. They may be afraid to go to public venues. They may have trouble sleeping or sleep too much. Appetites may suffer. Your child may be anxious when his or her people are not all nearby, and wake from nightmares.

Children frequently have concentration problems after a trauma, and their grades will suffer. They may regress developmentally: your independent youngsters may become clingy, or need help doing things they had been able to do on their own. They may avoid activities they previously enjoyed, and withdraw into themselves. They may become anxious at the thought of going to school, or of being separated from mom or dad.

They can also develop physical symptoms like headaches and stomachaches. They may try to exercise more control on their environment, setting up their toys in a particular way, wanting their schedule to be predictable, or demanding activities they find reassuring. Teens may act out or try alcohol or drugs in an attempt to feel better.

Helping them may be as simple as listening. Be available and receptive but don’t push. A younger child may open up and tell you his story when you break out toys or art supplies; an older one may talk if you tell her a similar story about yourself, when you were scared or worried. Schedule time for just the two of you, and wait.

Children may try to hide their symptoms: they think they should be stronger, they don’t want to be a burden, or they think they are abnormal for having the problem. They may even feel that the disaster was their fault; children are not always logical. Allowing them to bury their symptoms will only erode their spirit from the inside.

Also, be a good example. Take care of yourself, eat healthy food, sleep, and discuss events calmly. Turn off the TV and stay off the web. Exercise. Take breaks to play, read a book, and do something unrelated to it.

Keep to recognizable routines– routine is reassuring and safe. Require reasonable behavior: if they still get in trouble for using that bad word, then everything must be OK. They may test you with bad behavior just to get that reassurance. Don’t spoil them with extra treats, because it will frighten them. Things must be really bad if The Parent gives me toys or lets me eat candy.

Lend a hand to other people. It will help to know that you have the power to help and comfort.

The traumatic symptoms may last quite a while. Triggers like parents going out at night or a security guard at a local festival may bring everything back. Fear of it happening again may linger. An anniversary will renew their anxiety.

If time passes and stress is affecting their lives, think about having them see a counselor or getting them into a peer group with similar concerns. We all need a little help sometimes.

My mom also used to say, “Time heals all wounds.” And with a little help from their guardians it always will.

Donald Trump, and Accountable Parenting

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Cute girl of school age in superhero costume

Our current crop of political leaders is making me nuts. We’ve gone from “I cannot tell a lie” George Washington to “I cannot tell the truth” Donald Trump, and the American people have accepted it, because it is the new norm. What happened to honesty, integrity, and caring for our fellow humans? The politics needed to get elected have destroyed the integrity needed to do the job.

I usually tell people that the most important concepts in parenting are unconditional love, acceptance of and respect for the child, security, and consistency. In honor of this election, I would like to add one more to the list: personal responsibility. Perhaps I can sneak it in as a subset of security.

Eleanor Roosevelt said “…our children must learn…to face full responsibility for their actions, to make their own choices and cope with the results…the whole democratic system…depends upon it. For our system is founded on self-government, which is untenable if the individuals who make up the system are unable to govern themselves.”

Responsible behavior trickles down. When the individual people who run our government do not hold themselves accountable, our organization’s leaders will follow that example, and bad behavior will flow down to our workplace and family. If everyone you know is behaving badly, why then should you be any better?

Because your children are watching.

Our candidates have not been good examples.  According to the Pulitzer Prize winning website site PolitiFact Donald Trump tells the truth 3% of the time, and “Pants-on-Fire” lies 19% of the time. Ted Cruz is at 22% true or mostly true, and 7% Pants-on-Fire lies. Clinton and Sanders tied at 51% true or mostly true, and 2% and 0% fiery pants, respectively.

Recently I was asked if an online publication could put my blog about Food Marketing to Children on their site. I was honored, and said yes.

They edited it a bit. They took out every reference to particular fast food advertisers, thus gutting the info on marketing techniques advertisers use to attract children. Apparently it is unacceptable to offend McDonald’s by suggesting that they advertise fast food. They removed my book from my bio (hmm…) and replaced it with fabricated hospital affiliations. I was told that it would not be sent for final approval until I approved the edits, so I spent two days working to fix it. When I sent back the version I approved, I learned that the gutted article had been sent forward at the exact same moment they were assuring me that it would not.

When I expressed my disapproval, I was told “This is our editorial process and it has been in place for five years. It has never been a problem.”

It reminded me of Han Solo in Star Wars shouting, “It’s not my fault!”

“We always do it this way,” and “It’s the other guy’s fault,” are classic techniques to evade personal responsibility. Lack of accountability has become expected and acceptable. Bad enough in politics and organizations, it is soul destroying when done by parents in the sight of their children. “It was the other guy’s fault,” easily breeds “The teacher didn’t tell us we had homework.” “The boss just doesn’t like me,” can become “There’s no point in trying, it won’t work out anyway.” Evading responsibility imperils things like learning, achievement, self-confidence and pride.

We want our children to have pride in their accomplishments, good relationships, and success in their chosen work. The only way to get there is “to face full responsibility for their actions, to make their own choices and cope with the results.” Gotta love Eleanor Roosevelt.

The first step in teaching them to be accountable for their actions is to be so yourself. Children will follow the example they see–and if that example is not as honorable as it should be, they may not become the person you hoped they would be. Forget to pick up the school supplies? Accept blame and let them put you in the time out chair. Don’t try to shift blame to your demanding boss. Hurt somebody? Apologize. When we hold ourselves accountable, we become better people, and our children follow our example.

Getting the job is not the final goal; doing the job is.

One more quote, because Maya Angelou says it better than I ever could: “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

Make your children feel secure and proud to claim you as their parent-not disappointed and ashamed by your actions. Teach them that they can accomplish anything they dream of if they make their choices, and cope with the results.

And get out and vote.

Domesticated Momster

Your Kid’s Brain on No Sleep

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Tired Teenager With TabletEvery animal sleeps. Birds sleep attached to their branches, bats sleep upside down, whales sleep half their brains at a time–all of us need to catch some Z’s. Science doesn’t have a complete understanding of why we sleep, but we do have some ideas and we know people run into problems if they do not get enough.

Humans sleep in cycles from light sleep into heavy and then into dreams. Adults cycle about four times per night; infants cycle about every hour (that’s why they can wake up every hour). Each stage has a function: if you don’t get enough time in each stage you will not feel rested, even if you spent enough hours horizontal.

During the first stage, or “N1”, you are in drowsy sleep. You are not completely out, but neither are you completely aware of your environment. If someone sat beside you to read a book you would not notice; if that person said your name you would.

During N2 you loose all conscious awareness; N3 brings you into deep sleep.

Rapid eye movement (REM) sleep is the fourth stage. During REM sleep you dream, and your voluntary muscles become atonic, or mostly paralyzed, so you don’t whack yourself in the head.

Then you cycle through the phases again. Most deep sleep is early in the night; most REM sleep is later toward morning. (That’s why kids mostly wet the bed early in the night.)

If you get enough sleep you feel energetic during the day, your brain works and your emotions are under control.

The opposite happens if you, or your children, are sleep deprived. If your children do not get enough sleep they are tired, they cannot concentrate and they can be irritable.

Lack of sleep affects their working memory: the memory they employ constantly to reason and function. Without an effective working memory they will find it harder to make decisions. It will be difficult to focus and learn.

Sleep is necessary to organize, consolidate and solidify what your children have learned during the day, so it can be there the next day when they need it. There is even some evidence that REM sleep is necessary for your child’s brain to develop properly in the first place.

Many of these symptoms duplicate those of ADD, depression, and Oppositional Disorder. Sleep deprivation also affects the function of your immune system, your ability to heal, your growth hormone levels and your ability to lose weight–important stuff.

So how do you know if your children are getting enough sleep? Look at them during the day. If they are sleeping adequately they will wake up easily, perhaps without an alarm. They will be awake during the day, not sleepy, not dosing off when they are still. They will be less irritable. They will be able to concentrate, focus and learn.

If they are not getting enough sleep, getting more is a priority. Make sure there is enough time allotted in their busy schedules, and try to make bedtime the time of day that they are actually sleepy. Every person has a circadian rhythm that includes a time in the evening when they get drowsy. That time should be bedtime. It should be approximately the same every day, to avoid permanent jet lag.

During the day make sure they eat healthy whole foods. No caffeine please, no tobacco exposure (yes I mean you!) and watch that sugar intake. Also, they need at least twenty minutes of aerobic exercise every day to wash those stress chemicals out of their bodies.

Quiet things down about two hours before bedtime: no TV, no vigorous exercise. Turn on some quiet music, play a board game, or read a book. Lower the light level. Give your youngster a warm bath and read a bedtime story. Don’t even think of having a TV in the bedroom! Make their bedroom comfortable, quiet and a little cool.

Enough sleep is essential if you want a child who is not moody and has a functioning brain and energized body. If you are thinking your munchkin has a behavioral problem like ADD, Oppositional Defiant Disorder or depression, consider first whether he or she is getting enough sleep. If not, change what you need to to ensure that they do. Get that TV out of the bedroom, give them a healthy diet and enough exercise, and don’t expose him to cigarettes. Quiet things down two hours before bed. And get some sleep.

Domesticated Momster

What To Do When the Screen Goes Off

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girl with plantMedia addiction in children and the importance of limiting their screen time is a big topic in pediatrics this week.

The American Academy of Pediatrics has always recommended no more than two hours of screen time per day for children over 2 (none for those under 2), and they have lots of data to back that up. Adding to this was a recent study suggesting that toddlers who watched more TV than average were more likely to be bullied later in life: reported bullying went up 11% for each additional hour of TV viewing, over the average of 1 1/2 hours. Scary.

Time spent watching TV is not spent developing social and verbal skills, and not spent using and exercising young bodies.

Children sitting in front of a screen develop a disabling habit of being more passive in their interactions with others.

They put on weight because while they are sitting, with their metabolic rate near what it is when they sleep, they are frequently munching on snack food.

They are more likely to have attention problems because TV teaches them to experience the world in 5 minute pieces.

Last, their perceptions are significantly skewed because they take the behavior of characters and people on TV as normal. Which they are not.

It seems reasonable that since I am one of those pediatricians constantly nagging people to turn off their screens, I have a responsibility to come up with some activities they can do instead. All those hours to fill, and all those useful skills to learn!

Our children need the abilities that excessive TV viewing destroys: social knowledge and the ability to interact with actual humans, verbal skills, an attention span adequate to complete a project, and physical exercise. Let’s throw in knowledge of the real world too, just to be complete.

So, ten things to do after you turn off the TV:

  1. Read a book. I know, it’s obvious, but that doesn’t make it any less important. The most rapid development in the brain’s language and learning centers occurs between 6 months and 3 years of age; we need to take advantage. Just 15 minutes of being read to each day between 6 months and 5 years adds up to 500 hours of reading before they even enter kindergarden, boosting development in these areas. Daily reading in older kids improves their comprehension and speed, in addition to adding to their store of knowledge. Hit that library!
  2. Experiment with science. My all time favorite science site is at Roots of Action. They have experiments in all kinds of science, organized by children’s age and type of science, from astronomy to zoology. There is enough there to keep your kids busy all summer long.
  3. Be creative. Break out the crayons or paints and draw. Make music. Write a story. Perform a theatrical: what kid doesn’t love performing in front of their most supportive audience? Creation exercises and stimulates the brain, making it more imaginative and receptive to new ideas.
  4. Garden. Not only does your munchkin get to play in water, dig in dirt and make a mess, but he or she will also have the pleasure of seeing their plants grow and flower. There is self confidence to be grown along with those beans for diner, and those flowers for the kitchen table. Also, they learn a little responsibility along the way, because they won’t want their precious plants to wither and wilt.
  5. Have a cooking class. Again, you get pride of accomplishment (they peeled those carrots!). They will eat better, because they won’t want their own hard work to go to waste, and they will learn an undeniably necessary skill.
  6. Make a chore list. Exercise, a sense of accomplishment, and lessons on responsibility all wrapped up in one. Give an allowance for completed chores and you can have financial lessons as well.
  7. Play a sport. With them please and have fun, so you have family time and everybody gets some exercise.
  8. Learn a new skill. Summer is the traditional time for classes and camps. Learn to draw, play an instrument, ride a horse… Anything your child has shown an interest in, someone is out there teaching, if you cannot teach it yourself
  9. Volunteer. Aiding others in need will help them appreciate what they have, and will feed their souls. The right sort of volunteer activity can also teach useful skills: Literacy promotion (reading), working with the elderly (communication, patience),  hospital work (medical knowledge), food banks and kitchens (cooking and nutrition), and Habitat (building and repair) are all enriching.
  10. After all this activity, take a backyard vacation. Put out the blow up pool and some beach towels, and drink things with tiny umbrellas. Have a trail hike through the neighborhood with a campout at the end. Have a day in Paris, with a home made Eiffel Tower and a French dictionary. Go to a Broadway show produced by your favorite tiny actors. Backyard vacations are limited only by your imagination, never your wallet.

Who has time for a screen? There is just too much to do! Turn that box off and put away that phone!

Kids, Tech and the Social Media

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So, I’ve been thinking. (Never a good thing)

Would you consider signing your children up for an experiment? I would like to change the way they interact with every aspect of their lives, from how they see time, to how they converse with family and friends, to how they learn and envision the world. I would do this by attaching a devise to their bodies that they would have to consult thousands of times a month in order to function in society. Then we would set them loose and see how they turn out in 10 or 15 years. No safety net allowed!

What makes this experiment interesting is that you’ve already signed them up for it.

Kids these days see a clock as a series of minutes clicking by on a digital device, rather than as two sets of twelve hours, with high noon dividing the day in half – a completely different view of the progression of time from what has been traditional.

Teens text an average of 3400 times each and every month, adding both the immediacy of constant contact, and the distance of a fractional interaction, to every relationship. Are all these “friends” really friends? How easy would it be to substitute these relationships for real ones, which would require work, and personal contact? How will this affect them as their lives progress?

Children learn by searching the Internet, rather than by hitting the library. They won’t see the information in the paper pages surrounding the one they searched for, but they will see all the other stuff that pops up with their search words. It is impossible to know how this will shape their store of knowledge and the way they think, but it is undeniable that it will have an affect.

Video games are everywhere and unavoidable. If your image of a female is a comic with huge breasts and torn clothing, how does that affect how you see yourself, if you are a girl? If blowing things up and chopping at people with a sword are every day activities, surely that will desensitize you to violence.

Who knows what new tech will come out next year, or in ten years, and how it will change our world.

Exposure to the Internet and technology is impossible to avoid. Your children live in this generation, and will have to function within its norm.  The young man without the cell phone will not be invited to the party; the young woman who doesn’t understand the slang used by her peers will get an eye roll and be left standing alone. The intern who looks blank when the boss asks him or her to create a spreadsheet to perform a task or analysis, will not be hired.

If you were to decide it was not worth the risks and tried to limit your children’s access to tech, they would find a way. No one wants to be that kid, and the future demands they have the knowledge and ability.

So what sorts or results might this great social experiment yield?

First, a redefinition of privacy.  What was previously clear – behind the closed curtains, of course! – is now murky. Where does our personal space end, and shared space begin? Embarrassing baby photos in an album can be tucked away on a shelf. This generation will have a childhood full of embarrassing pictures logged on Facebook, for anyone to see.  What should be kept private, and how will we manage it? Perhaps people will become more kind, because they too will have bathtub pictures.

Everyone needs down time. Time spent away from work, away from even friends, is essential for our sanity, yet tech can always find us, and invades every inch of our space. We will need new rules to make us inaccessible in this age of texting, webcams and Skype. Perhaps a privacy button, with an automated butler to take a visitors card for delivery later, when one is “in”?

With knowledge available at the touch of a button, will our children be expected to know more? If information about the new guy’s culture can be had with a keystroke, what reason would there be for ignorance? Laziness, or intentional bigotry? There used to be a limit to our “pocket knowledge.” Now the world fits in our pocket. How do our children live up to that?

The world at one time rotated slowly, and generations could go by before any real change happened. Now every minute brings a new change. Will this make our children frightened and insecure? Or will they be more open to change, more engaged in every moment of the time they are given? Further, could they become change junkies, needing new things constantly to stave off boredom?

Where will this stream of new ideas come from? Creative geniuses are the rock stars of the future.  If creativity is valued above graces like beauty or strength, might our children be unleashed to let free their imaginations? Conversely, will the next generation be judged harshly when they lack technical skills, the way prior generations have been condemned for lack of athletic ability or beauty? Or can we learn to accept the beauty of human diversity, since it will be apparent on a screen in the palm of our hand?

In the same way it is hard with our current technology to maintain privacy, so will it be hard to maintain our distance from the rest of humanity. If we want to believe we are somehow different from and better than other humans, we have to do our best to not see and understand them. This is hard to do when a family suffering on the other side of the world can be on your computer screen instantly, and they can join into the stream of consciousness on your twitter feed.

It is impossible to know how technology will change humanity, but it is inevitable that we will be forced to evolve. So dive in.

Participate in your child’s experience with technology, and inspire them to use it to increase their understanding of the world and express their creativity. Show them the risks, and make sure they understand the responsibilities. Then step back and watch, because the Internet and the array of technological advances available now and into the future gives this generation, no matter their circumstances, the tools to understand each other better than any prior generation, and to do any amazing thing they can imagine. It will be an adventure!