Tag Archives: behavioral problems

You are not playing enough. Neither are your children.

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Children Playing.

Children Playing.
Photo courtesy of Pixabay.com

How often have you heard “Stop playing around?”

Is some adult’s voice from your past playing in your head right now as you think about that? Do you ever say that to your child or someone else? Well, knock that off.

The truth is we all need to play more and so do our kids. Now I am not talking about the high-pressure play of organized sports. We are hearing about a lot of kids getting injured playing competitive sports. That is not good for them and despite that delusion of our athletic prowess most of us older folks are not up to that stuff either. I am not thinking of the high dollar sports that are now a business and not fun. What I am suggesting is we all need to do more running and jumping, laughing, and having fun.

For a while we had a movement called the “new games” movement which said that games had become too formalized and rule-bound. People watched them instead of playing at them. So they started inventing new games with different rules. The fun was in trying something different.

Now some of you are saying we need to be serious, kids should learn the academics. No time for play in a well-organized society, except for a few professionals we watch occasionally. That would be all wrong. Kids who play around as children very often do better later in life than their serious compatriots. Let me tell you a story.

There was a school that assigned a teacher to a special education class. That class had such a reputation for not behaving that they were banned from the school-wide assemblies. But this teacher thought it wasn’t fair that her class couldn’t go and all the other classes got to. The other teachers made their class’s line up and march to the multiuse room for the assembly. They were certain that those special education kids could never stay in line long enough to get lined up. And if they were able to line up by some bundle of luck, they were sure to move around and disrupt the assembly. The newly assigned teacher had a different idea and she had a solution.

She did not march her class across the school in single file formation as the other teachers did. She had her class run, as fast as they could, laughing all the way, around the entire school grounds. Only when they had run as far as they could, did she line them up for the assembly. And the shock was, that after a good run those kids were better behaved than the other classes. The teacher was Violet Oaklander, and her book “Windows on Our Children” is a classic on the use of art and play as therapy. But there is more to the story of why play is good. We now know it is not only useful for treating children therapeutically. Play is also necessary for normal development.

Children’s unscripted play is important in developing skills that will increase learning in other areas and will be useful in later life. Play is useful for alerting, improving attention, and for helping people organize their thoughts. It is also calming for most people. Some adults are afraid that play might “wind kids up.” It may improve alertness; I wouldn’t recommend it just before bedtime. But before class, it is likely to improve performances not prevent it.

So if we have overactive disruptive students, what do some teachers do? They take away recess and keep the kid in. This is precisely the wrong approach. Please, no emails – you don’t understand – we need to maintain control. FYI, I teach also, I know the problem. But when students get restless then need more breaks and physical activity, not more amphetamine.

What else does play accomplish? Old fashion imaginative play also improves the ability to make use of the senses. It improves balance, fine motor skills needed for writing and the list goes on and on. There are also play activities that improve the auditory and visual senses, just the skills needed for effective learning.

The list of skills that might be improved by active play is too long for me to include here. Even video games when used in moderation, have some benefit in improving hand-eye coordination. Remembering I am not a big fan of robotic video game playing. I have seen too many video game addicts.

But Folks that’s not all!

Play improves the ability to bounce back from life’s stress and trauma. Various play activities have been shown to improve recovery and resilience. There is more to the topic of resilience and the ability to bounce back than just play. One of these days I plan to write more about why some people are able to bounce back from all the bumps in life’s road and others don’t seem to have those skills. I was researching the topic of resiliency and recovery when I came upon all the reports of the benefits of more play.

Hum – just might be a book lurking in that topic. Stay tuned for more on the resiliency angle.

So I hope you have gotten the message. Get out there and play some more. And encourage your kids to play more also. You might even get radical and try playing with your kids.

Is anyone reading this? What do you think about the topic of the need for more play?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Treatment for teen’s risky behavior

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Teens

Teenagers.
Photo courtesy of Pixabay.com

An amazing discovery in the treatment of risky teen behavior was reported over the last several weeks. It went largely unnoticed by most mainstream media.

Furthermore, one single treatment has been shown to have high efficacy in treating teen risky behavior. It is extremely inexpensive and can be obtained and applied without a prescription. The treatment, while often resisted by teens with high-risk behaviors, has been shown to not only be effective under a wide range of conditions but to treat a large number of undesirable teen behaviors at a very minimal expense.

In a startling report, two researchers for the Center for Disease Control in Atlanta Georgia found after studying data for over 12,00 U. S. high school students that a single deficiency coexisted with a huge increase in teen’s risky behavior. While the government report was reluctant to say that this deficiency was the cause of risky teen behavior, they speculate that this one key ingredient might reduce overall risk-taking in teens significantly.

Unfortunately, this key ingredient cannot be prescribed directly because it is not USDA approved for over-the-counter sales and is, in fact, available without a prescription. This one single item, not yet patented by a drug company, is available to almost all U. S.citizens for free.

High School students who were deficient in this one key item, and almost 70 percent of our teens were deficient, were almost two times more likely to be smokers. A continued deficiency if this ingredient, reported being necessary for happiness, resulted in a 50% increase in marijuana and alcohol use.

Long-term deficiencies in this factor were correlated with a huge increase in teen sexual activity. That was surprising since we most often have studied added factors that might cause an increase in sexual activity. Not many people would believe that a deficiency in a single ingredient necessary for life might increase the sexual activity of teens.

But wait – there is more, this deficiency doubled the risk for a suicide attempt. It was also related to getting into physical fights and being sad and hopeless. Kids who had this deficiency were also likely to be overweight, get less exercise, and generally have a less healthy lifestyle.

So what was this deficiency? And how can we supplement teen’s lives to overcome this insufficiency?

The deficiency was a lack of sleep! Sleep deprivation was significant in kids with all these problems. And the one simple cure was more sleep!

Now teens will resist sleeping more, especially sleeping during the night. It appears that most teens are truly nocturnal creatures. More than one adolescent who was brought in to the psychiatric facility has confided to me that they rarely get much sleep at night. An increasing number of kids have T. V.’s and computers in their bedrooms. Many are online texting friends or playing games until close to morning. They have to set alarm clocks to wake up and even then they often can’t quite get it together in the morning.

Eventually, a teen who stays up most of the night finds they can’t function in the daytime. They are at risk to fall asleep at school, cut class or just plain be grouchy and get into fights and other negative behavior.

So it just might be that one thing a parent might do to improve their teen’s life is to make sure that child is getting enough sleep, even if that means restricting electronic avoidance of sleep.

Be careful if your teen has been avoiding sleep on a regular basis. If you suddenly try to take away their electronic addiction your teen may go into electronic withdrawal. During withdrawal from electronic sleep avoidance teens have been known to become grouchy, throw things break things, swear or even threaten to harm themselves or others. In extreme cases, you may need professional help to get the teen back on a night-time sleep schedule. But if your teen is having difficulties in life you just might want to examine their sleep habits and see if more sleep might improve their mood and behavior.

More sleep might improve your mood and emotions also. What do you think?

Till next time. David Joel Miller, LMFT, LPCC

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Three-year-old judge decides right and wrong

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

child

Child.
Photo courtesy of Pixabay.com

6 ways to tell right from wrong.

Preschool kids seem to be so very good at telling what is right or fair. They tell us often enough – “That’s not fair!” So how come they so often do things that we say are wrong? Maybe we should appoint three-year old’s to the Supreme Court? Is the understanding of right and wrong something people are born with or do they learn it? And if they learn moral values, how do they learn it?

In the early grades the ways in which kids decide the difference between right and wrong starts to change, at least for some of them. It is important to understand how it is that people learn right from wrong. Why some don’t seem to learn might also be a good thing to find out.

People who study child development probably learned about some theories of how an understanding of right and wrong developed. Counselors are often taught about the stages of moral reasoning, in some developmental classes and then seem to promptly forget it once they start working with real clients. But isn’t right and wrong, and conflicts over how that should be decided one major reason we see clients in counseling?

Lawrence Kohlberg researched and wrote about moral development. So did Lickona who wrote a very readable book “Raising Good Children.” I would recommend it to any parent struggling to teach their child the difference between right and wrong. Somehow all this work is getting forgotten despite the constant reports of high crime and failure of discipline in the home and school. We spend a lot of time these days emphasizing math and science in schools, but less and less time in our homes and schools is spent on right and wrong. So how is a sense of right and wrong likely to develop? Let me give you a brief description of Lickona’s ideas as I remember them. For the full details you might want to look for the book but here is my short version of the 6 stages of moral reasoning as I understand them. Lickona numbers the stages zero to five. The fact that he arranges them this way does not mean everyone agrees that a lower numbered stage is, in fact, better than another stage with a larger number.

0. Getting what I want is fair!

This is the default way of deciding right and wrong. It’s not fair – I wanted ice cream and I didn’t get any. Some people seem to be able to go through their whole life thinking this way. They take what they want and that is fair to them. Some of them go to prison. Some learn to hide what they are doing. Some of these folks end up elected to public office or working on Wall Street. These folks make lawyers rich when they try to get out of trouble for doing what they want. If we don’t want more of these folks around we need to work on teaching kids the more advanced ways of deciding right from wrong, or we need to build more prisons.

1. The teacher said – the authority approach.

Some kids learn this at home before they go to school, for a variety of reasons. Most kids learn this in school. It starts by learning to do what the teacher says. Eventually, the appeal is to some higher authority like the principal. Some people get really legalistic. It says on the page — of the revenue code, that I can do this so it must be right. In some places, with statute law, if there is no law against it, you can do it. In most places in the United States, we have the common law which says you should use common sense unless there is a law otherwise. Then we have lots of layers of appeals courts because we are so short on common sense. We see lots of people who appeal to religious writings as their rule book, sometimes to good effect and sometimes to some awful results. The problem here is not especially with the particular religious writing, but some of the bizarre ways people can interpret those writings. The philosopher, Charles Shultz once reported, something to the effect that “There is nothing in the book of Leviticus that prohibits the wearing of contact lenses.” See how hard I am trying to be politically correct here?

Some people would separate “The Teacher said.” part, from the “The rule is.” Both are resorting to authority but one is putting your faith in a person and the other in some specific set of rules.

2. One hand washes the other.

This commonly heard, usually, in business, expression says right and wrong is something we trade.  We take turns. Most kids learn this on the playground really fast. If you don’t take turns with the ball you may not get to play at all. In Congress, this is called trading votes. You vote for my bill and I will vote for yours. It is pragmatic, gets things done. But is it the best way to determine right and wrong? We need to study this. Send me a million or so in federal money and I will be glad to work on this approach. At a million dollars a year we may need years of study. See how problematic trading one thing for another might be as a way to separate right from wrong?

3. I want you to like me.

So if I want you to like me I should do what you think is right. This is the “what will people think of me” approach. This type of social conformity can keep people acting in a socially positive manner – sometimes. The issue here is what people’s opinion do I care about? This goes to the discussion of peer pressure which I wrote about in an earlier blog. Take a look at that one – now if you want, it’s ok. I can wait here while you look.

You back? So you see that if my peers are good law-abiding people I probably will follow the law. But if my social circle includes convicts, murders, rapists, bankers, politicians, and other undesirables, I might decide that stealing your money was an acceptable thing to do, so long as I steal it using the same methods as my peers.

So using other people’s behavior as a guide to right and wrong may reduce the conflict we have in life, but it is no sure way to figure out right and wrong or to stay out of prison. Ask the group from Enron.

I may be a little hard on this stage. It is great to be a good son or daughter or a good parent. But that may not be enough, especially if you didn’t have good role models. This step in the development of morals is mostly about your relationships with people close to you.

4.  What is best for all of us?

This is the stage where people may do things that have personal costs because it is the thing that is best for our society. This stage of moral reasoning gets people to join the military or become volunteers. This is an altruistic stage, most of the time. It is also a way of moral reasoning that has been used to excuse some horrific atrocities.

Today in America we value diversity. Some of us do anyway. But can you see how someone in another place and time could do some awful things and justify it as “what is best for us?” Think genocide here. Could someone do that thinking it was what was best for their group? The difference between being a volunteer to work with the poor and trying to run a minority out-of-town hinges on who you define as us.

5. Some things are right just because they are right.

This is an easy one to explain in theory, until you are faced with the choice, then it is easy to default to an earlier stage of moral reasoning. Sometimes people are faced with things going on in their society that are just not right. And often it costs to do the right thing at these times and for sure there is nothing in it for you when you do the right thing at these times. This is about respecting everyone just because they are.

So there is my explanation of stages of moral reasoning as I understand them. Can you see how hard it is to figure out the right thing to do sometimes? Some parents are able to teach their children right from wrong despite all the influences around them to the contrary, but what about the other kids? It feels to me like we should spend more time in our society on the ways to determine right and wrong and less on some celebrity’s outrageous behavior. But that’s just my opinion. What do you think about how we learn to tell right from wrong?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

6 Rules for surviving your teen

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Teens

Teenagers.
Photo courtesy of Pixabay.com

When the teen years arrive, armed combat begins.

How do you survive your teen unharmed?

Sometime between eleven and thirteen that cute cuddly kid turns into an unrecognizable scratching clawing creature. Once in a while, the parent gets away unharmed but not often.  Parents say they don’t know what happened to their child. They don’t recognize this kid. So what happened?

How do you survive the teen years and is there a life after teens? Here are some ideas; maybe we could call then rules for those years.

1. Don’t try to hold the lid on the boiling pot.

You have spent a decade on more raising a generally civilized child, as the teen years approach and the emotions boil parents often make the mistake of clamping down. Suddenly the cute little daughter who everyone likes – well – the everyones who likes her, are no one you would want around. The result is trying to keep her in. “No dating till you’re thirty,” the parent says. Then the battle ensues. Parents try bolting the windows in her room shut, but like a magician, she somehow gets out. Parents put kids on monitoring. Call me every hour. The kids retaliate with more excuses than a congressman.

Controlling a teen, especially an older one by force is likely to wear you out and have no effect. Sometimes parent’s efforts to make the kid behave turn into violence. Sometimes the parent resorts to hitting the child, always a bad idea. You may discover you no longer have it in you to go ten rounds with a younger and stronger opponent. I have seen parents seriously hurt by their kids. The other, more serious problem with using force on a child is it teaches them to use force and there is no end to how far this will go. So rather than trying to keep the steam in the kettle by holding the lid down, try directing the steam where you want it to go.

As the teen approves adulthood parents may need to learn to discuss and even negotiate things with their offspring. I am not saying let the kids take over the house, but you do need to teach them how to handle more adult responsibilities. By sixteen or seventeen you should have taught your child the difference between right and wrong. If you haven’t it is probably too late and someone with more control than you will need to take on the job, someone like the police or parole. You need to keep up hope that the child will survive, unharmed, the episode of moral amnesia that so many of them experience.

2. Do not try to overprotect them!

You spent ten or more year protecting your child, every “good enough parent” does. Suddenly the experts tell you to stop trying to protect them. I know they will be sixty and you will still feel protective towards them but the teen years are the time for loosening the restrictions, not tightening them. You had to let them ride their bike without your hand on the seat, now you need to let them try some more adult things.

Every night in crisis centers around America we see kids whose parents have always been supportive or permissive, who suddenly engage in a life or death struggle for control with their teen. Kids who had no curfew now chaff as the parents set limits.  Parents worry about drugs, alcohol, driving, and mostly sex. They try to keep their kids safe by keeping them away from the risks – that won’t work.

One day they will turn eighteen and then they will be allowed to make all their own decisions. Some kids start before that. There is no magic cloak of maturity you can give them on that occasion.  You need to begin now teaching them how to be responsible adults and one way they learn that is to try things and see what works and what doesn’t. Increasing rules and restrictions may feel like it is protecting your child but it may also be delaying the growth of maturity.

3. Notice when your child does something right.

Many kids report the only time their parents notice them is when they are correcting them. Constantly finding fault with teens is not likely to make them perfect. It often results in kids who are highly anxious, afraid to do anything because they are sure they will never be able to do it right, or you get kids who give up trying. If the only way to get your attention is to mess up, they will mess up on a daily basis. They are after all giving you what you are requesting. You will get more of whatever you attend to.

Now I am not suggesting hollow praise here. Kids can see right through praise that was given to increase self-esteem but which they see as just something everyone is able to do. What I am suggesting is that you need to pay close enough attention to your child to know when they do something noteworthy and then let them know that you noticed and approved of that.

4. Be their parents, not their friends.

Kids should be kids and parents should be parents. Sharing your drugs with your child does not make for a good relationship. It makes for a child who does not know how to observe boundaries. And even worse are the parents who flop back and forth. One day you want to be the kid’s best friend, maybe even keep a secret from the rest of the family, the next they come down on the kid with all their force because the kid is not doing what they want.

5. Know the difference between rewards and punishments and bribes and abuse.

Lots of people in our society don’t seem to know this one. From the way we see celebrities and politicians acting you would think they are the same thing. They are not.

Rewards and punishment should be directly related to the person’s actions. For adults, this is easy to explain. If I show up for work on time and do my job I get a check. If I am late, I get docked some pay. If I keep coming in late I may lose my job. Parents get this confused and send the child to their room for getting bad grades. Bad grades should get more study time. Going to your room should be a punishment for not behaving around others. See there is some connection between the two.

Do I need to say that some of the punishments I see require me to report the parent to child protective services? Don’t ever let the punishment get out of proportion to the action. When it does it can turn into abuse. This is especially true of physical punishment and name-calling. Calling your child stupid will not improve their grades; it will make many of them stop trying.

6 Pick your battles

Parents, especially of late teens begin to get desperate. Time is running out to teach your child how to behave, especially if you have a strong feeling they should behave exactly the way you want them to. So every day becomes a battleground. The chances that your child will turn out perfectly are not especially good. They all have their flaws. So do their parents.  Unless you really like to fight, day and night, I suggest you reserve your line in the sand efforts for the really big things. Which is more troublesome, your teen’s messy room, or their drug habit?

Like all advice, these rules are easier to say than to do. My hope is that this is helpful to someone out there. If you have comments or suggestions please comment on this blog.

So there you have them, 6 rules for surviving your teen.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

ADHD Cure- – Treat Parents

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Sad child

ADHD?
Photo courtesy of Pixabay.com

Could we cure ADHD or depression in children, especially preschool children, by treating the parents?

Just read a report that concluded that the epidemic of ADHD in preschool children can be very effectively treated by training the parents in Parent Behavioral Therapy (PBT). This raised a lot of questions. Why the increase in ADHD? Why in Preschool children? And most importantly how could treating the parents – cure the children?

The Press Release about the report by the McMasters Center can be found here. 

The McMasters center report suggested a different way of viewing ADHD and the older ADD. As I understand their concept they are convinced there is one larger umbrella disorder – Disruptive Behavior Disorder meaning the kid is doing things or not doing things that cause the adults problems.  This more general description, which is a recognized diagnosis in the DSM-4-TR they then subdivide and refine into ADHD in all its varieties, Optional Defiant Disorder, and finally the most severe form Conduct Disorder.

This makes sense to me since most of the referrals for ADHD screening begin with things like – he won’t stay in his seat, is not doing his work, etc. These are complaints teachers and parents have, not things a child, especially a preschool child would complain about. Hence the child’s behavior disrupts an adult’s life and the diagnosis. They report that this disorder began with the label of “minimal brain damage” but when no one could find the specific brain damage we dropped that label.

Further, the study says that ADHD should be thought of as a spectrum disorder. So it might vary from no problem, through milder forms to “for sure you got it” forms. This like so many other mental illnesses are not a case of you got it or you don’t but rather how much of this disorder do you have. Also, there is no medical test for ADHD. We use screening tests and other ways of diagnosing this but the truth is who gets the diagnosis depends on who does the diagnosing.

So why an increase in ADHD cases in preschool children?

Calling them preschool children does not mean that they do not attend school. ADHD and related problems first began to be recognized about 1902 when most children on earth began to attend mandatory universal education.  Now a large number of children are attending preschool – hence lots of preschool-age children are attending school. The report on effective ADHD treatments included all children under six in the preschool group. They especially noted that at this age it is difficult to separate the effects of a condition like ADHD from normal maturation.

I think young children – by definition are immature, so we don’t diagnose “too young” as a condition unless they don’t act like we want them to then they have some kind of disruptive behavior disorder. Some countries in Europe have children wait until they are at least six to start school on the premise that before six they are too immature to benefit from school. In America, we go the other way and start them out at age two or three on the premise that the younger we start pushing them the sooner they will grow up.

So who gets diagnosed with ADHD?

Most new diagnoses of ADHD occur when children begin to attend some form of formal education and are asked to sit still and concentrate on things the adults want them to learn instead of the things kids want to learn. The majority of diagnoses are made between the ages of five and ten years of age. Diagnoses of ADHD after the sixth grade drop sharply and those first diagnosed after age eighteen are even rarer.

The majority of those diagnosed are boys. In fact, boys in the primary grades are four times more likely to get the diagnoses than anyone else. In my own experience, the time children are more likely to get referred for assessment for ADHD is when they first start school, preschool, kindergarten, or first grade. The next big surge in referrals is between the third and fourth grade when there is a shift from learning to read to reading to learn, and the poor readers get really bored.

The number of adult cases is half of those in children, so either a lot of people outgrow this condition with or without treatment or it is not so much of a problem once you are out of required school.  Or maybe a lot of kids get the diagnosis because they are bugging someone in the position to make a diagnosis.

The poor, especially those on Medicaid are much more likely to be diagnosed, but the rich (higher Socio-economic status) are much more likely to receive medication. The poor are more likely to stop taking meds after one prescription. For much the same reasons the poor are much more likely to drop out of parenting education programs.

When meds work for someone it is wonderful, unfortunately, the only way to see if a med will work for you or your child is to try it and there are side effects to worry about. Note that any meds may have side effects but some are worse than others.

In very young children – under the age of six, treatment with a stimulant ADHD med is likely to reduce the ADHD symptoms, but it increases the depression and other mood symptoms. Or maybe the sadness was always there but it becomes more noticeable when the child is able to sit still. The meds also suppress growth, something that a forty-year-old who is overweight might hope for – but not something we want to see in a child under six. And there is another problem.

In one well-documented study children who took a placebo – a non-active pill – did almost as well on managing their ADHD as children who took the real med. When the meds were stopped, 97.5 % of the kids on ADHD meds did not have a relapse, pretty impressive. But of the kids on a placebo who were treated with nothing resembling a drug other than the pill form it was given in, well a full 88% of these non-medicated kids did not relapse either. The conclusion here could be that the thing that helped the kids was the extra attention involved in treatment, not the medication.

Now, why not just send all these kids for therapy? Well as much as that helps some kids, and remember I am a therapist, there is a limitation on therapy. We see the kid for one hour a week. What happens the other 167 hours? So when parents take a class in Parent Behavioral Therapy or work with the therapist on how to help their child, they are able to maintain the treatment all week not just in the therapy hour.

Now if your child is on meds, please do not suddenly take them off, talk to your child’s doctor or psychiatrist first. But for very young children consider approaches other than medication.

The moral of this story? The more we adults work on our skills the more we can help kids with ADHD, with or without medication. So if your child has ADHD or depression or any other emotional problem, consider participating in therapy and learning new skills that might help your child.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

“Speeding up” the third grade

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Sad child

ADHD?
Photo courtesy of Pixabay.com

There must be a connection between Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder, and behavioral problems like Disruptive Behavior Disorder. If they are not connected why do I see so many children who progressively get all three diagnoses?

Recently a child was referred for assessment. The parents were concerned their child might have ADHD. They had been sent by the third-grade teacher with a stern warning that they needed to get this child help before it was too late. The teacher pointed out that she had been teaching for a great many years, she had seen many ADHD children, and that she knew a child with ADHD when she saw one. She was certain that this child had ADHD and needed medication. The teacher had told the parents she was sure of this because the child was in the bottom third of the class.

This troubles me. Now I know that there are people who suffer from ADHD. I have worked with adults who were unable to stay focused enough to succeed on a job without their medication. I have seen children with ADHD who have been struggling in school and then they get put on the right medication. It can work miracles. But this was different. If we are going to refer every child in the bottom third of the class for medications what does that say about us and our educational system? Really does that mean one in three children has ADHD? I find that hard to believe.

Now if this was an isolated incident I could explain it away. But this sort of thing is happening more and more.  Another parent shared with me that they were pressured to have their child evaluated for ADHD. The school had said that the child did not stay in their desk or do their work. Further, the parents were told that if the child continued to ignore the teacher and not do their work they might have to be placed on homeschooling. This parent took the bold step of talking to other parents in the class. Turns out that in this class of about thirty students more than half were on ADHD medication, most of them referred by the teacher and principal.

Have we reached the point where test scores are so important that we need to put a third of a class on stimulant medication to get their test scores up?

And if taking pills to get smarter really works, if drugs make kids smarter, than why only the bottom third? Aren’t we then cheating the top third by not giving them the drugs so they can do better also?

What also bothers me is the number of children who are diagnosed with ADHD who are subsequently suspended, sometimes expelled for fighting and violent behavior. I know from my work with substance abusers that when they abuse stimulants they are more likely to become violent or otherwise act impulsively. So could a stimulant ADHD med increase the child’s level of violence and result in him being expelled for behavioral problems? I asked a couple of psychiatrists about this issue. I was told that yes a side effect of some ADHD medications is an increase in violence.

On interesting new development in the field has been the availability of several newer drugs that are non-stimulant ADHD medications. While every medication has its side effects, and these meds are no exception, if the medication we are giving a child is making the problem worse not better shouldn’t we consider other options? I would if it was my child.

Now, remember here I am a therapist and not a doctor so if this gets you thinking how about talking with your doctor? And please don’t just suddenly stop giving or taking meds without consulting your doctor.

Here is another example of this problem. A child was referred for assessment. Please hold your CPS dialing finger till you read to the end. The caregiver, an older sibling, was trying to help her younger brother. He was constantly in trouble at school. Did not do his homework, daydreams in class, and would not stay in his seat. The teacher (different teacher this time) was sure this was another classic case of ADHD. The sister told me she tried to do what she could but she and her baby’s father were living with friends in a motel room and there was no place for this young man. Still, she was his school contact and she came to help him when she could. His primary care doctor had prescribed ADHD meds, but the minor still was not doing his homework and was not paying attention. His meds had been increased and still no improvement. What to think?

So I interviewed the young man. He reported his father was not around. Bio Father was in prison and would not be released for a few more years. He was staying with his mother but she was in jail right now and would not be released until Monday. So in the meantime, he had been staying with relatives. He had slept on the couch, several different couches for that matter, different relatives on different nights, and most of these homes were small and overcrowded. He had not slept well or eaten well since mom had been arrested. He was sad all the time and nothing made him feel better anymore. So was my diagnosis ADHD? Not on your life. Clearly, this young man was suffering, and I do mean suffering, from depression. The end of the story is, mom was released, the minor, and mom found a safe place to stay and the child is in counseling. I hope mom gets some counseling also.

Did I mention the referral for ADHD whose father was just deported and dad will not be allowed back in the U. S.again? He refuses to do his homework, will not listen to the teacher, and – Well you get the idea.

In each of these cases and so many, more, the first diagnosis was ADHD because of poor schoolwork, inattention, and not following rules, like being out of their seat. Later when the medication did not fix them they get diagnosed with some kind of disruptive behavior diagnosis. But in most cases when we look really carefully there was also a lot of depression and sometimes eventually a manic episode occurs and the diagnosis changes to Bipolar Disorder. Not every child who does not do homework has ADHD.

If you have had an experience with this issue or thoughts you would like to share please contact me. So much for my thoughts on Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder, behavioral problems like Disruptive Behavior Disorder, and Depression.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel