Thursday, October 2, 2014

Survival Strategies with Parenting Children with ADHD



  • Be Available During Homework TimeBe present and talk through what assignments need to be completed. Once your child begins to work on his assignments, you then can complete the tasks you may have to complete. If your child asks you to leave, consider going to another part of the home, as long as he or she is working on their assignments.
  • Increase Physical Activity. Studies suggest a connection between physical activity and increased levels of alertness, mental function and learning. Physical activity increases blood flow to the brain, allowing for increased levels of glucose (brain food) to the brain, while releasing endorphin's, which are shown to improve mood. Encourage your child to bounce a ball or walk around the house while reading aloud from a book. Your child will eventually settle down and be able to focus on their work more easily.
  • Use medication. Most children with ADHD are mentally exhausted upon returning home from school. This often poses significant challenge for completing homework. Discuss with your doctor additional options such as, prescribing a medication that is short acting/ quickly absorbed. Children are able to remain focused, complete assignments and recall the material they studied when prescribed medication.
  • Arrange the environment. Although the end of the day may be approaching, homework still has to be completed. Getting your child comfortable and reducing interruptions/distractions improves his or her ability to complete homework. Create an inviting work-space free of the TV and cellphone. Have your child sit away from anything that could distract him from completing homework.

  • Make it more fun and it will get done. Homework can be difficult and exhausting. The idea of coming home from a long day of school, only to begin the process all over again can be dreadful. Develop a reward system for homework assignments. You can reward your child with additional privileges such as increased television time or a later bedtime on weekends after homework is completed. If your child is studying for a test, turn it into a game of jeopardy or allow him to also ask you questions. Math, Science and English are some of the subjects that tend to tedious for children. Spice it up a bit.

  • Periodically take a break. Allow your child a few minutes to rest in between subjects. Don’t expect your child to complete each assignment one right after the other. Consider also working for 20 minutes then allowing for a short break before moving to the next 20 minute segment.    
  • Find a tutor. Depending on your schedule, you may find it hard to help your child with assignments. Consider hiring a tutor or locate an after school program where your child has a teacher available for assistance.
  • Organize assignments in their appropriate folders.  Have your child place their homework in the designated folder and place it in his schoolbag the night prior. Develop a system with his teacher to ensure that his assignments are being turned in daily. 

Thursday, July 10, 2014

To Praise or Not to Praise Your Chilldren

In the past several years there has been some discussion among parenting experts and researchers regarding the value of parents praising their children.  Some researchers  have even reported that inflated praise can harm children with low self esteem. One article in New York Magazine carried the following, alarming headline “The Self Esteem Movement Backfires—When Praise is Dangerous.” Another headline in a Psychology Today article read, “Praising Children With Low Self Esteem Can Backfire.”The headlines appeared to be more attention seeking than informative. The actual research projects provided some interesting and helpful information for parents about the best ways to praise their children.

Some researchers  looked at the effect of praising a child’s intelligence vs. praising a child’s effort.  Other researchers  looked at the effect that  inflated or exaggerated  praise has on a child with low self esteem Dr. Carol Dweck, along with a Columbia University team, for ten years studied the effect of praise on students in 20 New York schools.  Researchers would take a single child out of the classroom for a non-verbal IQ test..  When the researcher told the student his score,  he would be  given a single line of praise.  Randomly divided into groups,  some were praised for their intelligence. They were told “you must be smart at this.” Other students were praised for their effort.  They were told, “you must have worked really hard.”

In follow up research, students were given the choice of taking a  more difficult   second test  or an easy test just like the first test.  The students were also  told that they would learn a lot if they took the more difficult test.  Of those praised for their efforts,90 % chose the harder test.  Of those praised  for their intelligence, a majority chose the easy test.  Other subsequent  tests,  so  hard that all of the students failed,  looked at the two groups of  students’ response to failure. Those praised for their effort on the first test, assumed that they hadn’t focused hard enough on the difficult  test.  Those praised for their intelligence assumed that their failure was evidence that they really weren't smart at all.”


At the end of her 10 years of studying the effects of praising students for their intelligence vs praising students for their effort, Dr.  Dweck  concluded”Emphazizing effort gives a child a variable that they can control.  They come to see themselves as in control of their success.  Emphasizing natural intelligence takes it out of the child’s control and it provides no good recipe for responding to a failure” .
Dr. Dweck, based on  some of the findings from   her ten year study ,  went on to develop a   theory of two different  mindsets that she believes  shape our lives and our brains.  LS Blackwell,  a member  of Dr. Dweck’s team, took the study one step further. Acting  on the findings of the previous tests , Blackwell took a group of students who had a history of decreasing math grades. A total of 50 minutes were spent  teaching the students a single idea: that the brain is a muscle, giving it a harder workout makes you smarter.  That alone improved the students’ math scores.  

In another university, research was done looking at the effect that inflated or exaggerated praise has on children with low self esteem.  Eddie Brummelman and Brad Bushman conducted research at Ohio State University in which they found that adults seem to naturally give more inflated praise to children with low self esteem.

For the research, inflated praise included one additional adverb such as “ incredibly” or an  additional adjective “ perfect.”  An example of simple praise would be, “you’re good at this”  while “ you’re incredibly good at this” was considered inflated praise. The findings of this study showed that children with high self esteem seemed to thrive with inflated praise,while  those with low self esteem, who had been given inflated praise  actually avoided attempting any new challenging work. Brummelman said their findings suggested that the inflated praise may put too much pressure on those with low self esteem. “ They may think that they always need to do incredibly well.”  Bushman in an article for Psychology Today when providing a conclusion regarding the Ohio research says it is important when praising a child to focus on behavior or the process of the behavior  vs praising the good qualities of the child.   

The overall message for parents seems to be  that  praise for children needs to be sincere, specific, contain no exaggerations, and the focus of the praise should be on effort vs. the achievement or intelligence of the child. 





Thursday, April 24, 2014

10 Effective Tips to Manage Your Anger

Take deep breaths while lying down or sitting. Breathe in filling your lungs for 5 seconds. 

Hold your breath for 5 seconds and then exhale for 5 seconds.

Visual Imagery- Imagine a peaceful and relaxing scene. Maybe imagine a place you went to on vacation such as the beach. Imagine the sounds, smells, and sights.

Walk away from the situation contributing to your anger. 
Count to ten. Slowly count and think about how you want to respond to the situation.

Find humor in the situation. Try to make light of the upsetting event.

Listen to soothing and calming music.

Meditate. Concentrate on breathing and clearing your mind of the negative event.  

Journal your thoughts and feelings to diffuse your anger. 

Express your anger in a healthy fashion by using "I" statements. Assertively communicate your thoughts, feelings and needs. 

Get some exercise. Channel your negative feelings into a healthy physical activity such as yoga, bike riding or walking. 

Replace the negative thoughts with inspiring words or thoughts.  





Improving Family Dynamics - Traits of a Healthy Family

1.  Family members communicate openly with each other
     and also feel listened to.

2.  Family members support and affirm each other.

3.  Family members respect and trust each other.

4.  Family members make the time to do things
     together as a family.

5.  Family members have positive, optimistic attitudes.

6.  Family members work together to develop effective
     problem solving skills and coping strategies.

7.  Family members have a good sense of humor
     and have fun with one another.

8.  Family members have a strong commitment to
     the family and have a sense of belonging.

9.  Family members don’t take each other for granted—they show
     appreciation to each other.

10.  Family members have shared spiritual values.

11.   Family members share responsibilities. 

12.  Family members respect privacy. 

Complete a family assessment to determine if your family has these traits.   Each member of the family should look at the traits mentioned above and give your family a score of 1 to 10 for each of the traits.  Share the scores with one another to identify weak areas and encourage a discussion that can help you improve these areas.




Wednesday, March 19, 2014

A Broken System – The Elderly and Hospital Care

   According to the Chicago Tribune, in 2011, the Illinois Department of Public Health received 560 hospital complaints for inadequate services. Allegations ranged from patient abuse, inadequate infection control to more serious violations such as death. Of those 560 complaints, Illinois officials declined to investigate 85 percent due to a lack of funding. Many of these complaints also failed to reach to a federal level, thus many of these allegations were not further  investigated by the U.S. Department of Health and Human Services. So who is ensuring the welfare of hospital patients if hospital staff/administrators and state/federal officials fail to investigate allegations or complaints?  When someone is admitted to a hospital, it is expected that they are safe and given quality medical care.  It also is expected that nurses, physicians and other staff effectively communicate with one another to ensure adequate care is being provided. Recent events that have occurred with my elderly parents have in part contributed to writing this article. The objective of this article is to increase your awareness of inadequate patient care and encourage you to speak up and not remain silent if something similar were to happen to you.


   In December 2013, my father required emergency hospitalization to a hospital in the western suburbs of Chicago. The hospital he was transported to was not our first choice. However, paramedics don’t transport you to the hospital of your choice. Right from the start, I questioned if the ER nurse was adequately trained on how to communicate professionally to patients. This incident though appeared to be the least concerning of the many incidents that occurred during his hospitalization.  The one incident in which I am still trying to understand is how my elderly father who happened to be hospitalized for disorientation, fall in an intensive care unit? Is it not common knowledge that the intensive care unit specializes in treating severe and life threatening illness thus requiring the patient to be closely monitored? Unfortunately the poor care did not stop in ICU. Other serious incidents which occurred were the overuse and misuse of a highly potent benzodiazepine. The reasons for the use of this drug were never documented, nor were we informed that the drug was being administered. Despite our numerous requests to nurses and directors to have the drug removed, the drug continued to be administered. We were informed by one nurse that  staff administered the drug because my father was agitated and restless. Restless and agitated?  Is this enough to administer a highly potent benzodiazapine to an elderly patient with a history of dementia, pulmonary disease, heart and kidney failure?  If restlessness and agitation were sufficient reasons to administer this drug, then the entire world’s population would be on it at some point. At one point we were told that he may become dangerous, thus they administered the drug for everyone's safety.  The humor with this is that my father is a 5 foot tall, frail, 87 year old man, weighing 120 pounds when wearing his dentures.  How dangerous can he be? If there was concern about his safety maybe they should have been proactive and used the bed alarms which commonly are used with dementia patients who wander. Better yet, maybe they should not have administered as many doses of benzodiazepines as they did. 

   In a healthy individual, the half-life of the drug used (the amount of time it takes for the body to excrete at least half the drug) is 12 to 15 hours. For my father, that number is substantially higher due to end stage renal failure. The number of times in which this drug continued to be administered despite communicating with directors and nurses was quite alarming. Even more alarming is that they used this drug despite it being contraindicated in individuals with a history of pulmonary disease and kidney failure. Could the known side effects of this drug i.e. strong sedation/hypnosis, dizziness, drowsiness have contributed to his fall? Despite speaking to the patient liaison department, 3 different nurses and 3 nursing directors; the drug continued to be administered without consent.  It is quite alarming that my fathers records failed to specify our requests nor did anyone bring our concern to the doctor. No matter whose attention our concerns went to, no one seemed to take the matter seriously. I cannot count the number of times I was told someone was looking into the incidents. While we were trying to manage all of the above and get some answers from doctors, we were concurrently dealing with my mother having been transferred to hospice. Well, hospice is what they called it but obtaining the services appeared to require an  act of God.  We waited three days to transfer my mother to hospice and only were given a room when we went up the chain of command. The time we waited for the room was alarming however, what was disturbing was that we were told by one of the nurse administrators that they did us a favor by placing both of my parents on the same floor.  How compassionate of her!  What about addressing your staffs failure to communicate with not only the family but also with the physician and other hospital staff?  Unfortunately,  many people receive below average standards of care while hospitalized. Millions of people worldwide are harmed by poor hospital care each year. Despite one’s deep involvement with a family members care, significant negligence and inadequate care continue to occur. I can’t imagine what happens to those who don’t have advocates or family members involved in their care. Is it worth it to pursue a concern about quality? For many of us, it's not easy to act on a concern about the quality of care we or loved ones receive. The process can be stressful, frustrating and quite honestly emotional exhausting. And in the end, it's possible that others may not agree with the way we see the situation. Is it worth the time and energy to take action on concerns about the quality of hospital care?  Only you or your loved one can decide. In making the decision, think about the continued harm that might take place if you do nothing.  And think about how the actions you take might lead to better care for future patients. 

Why do Children Lie?

Kids lie for many of the same reasons adults lie. Some of the most common reasons children lie are: 


To get out of trouble.
To avoid punishment
To get others in trouble.
To protect their friends.
To make themselves look better to others.
To avoid embarrassment.
To impress authority figures and gain power in the process.
To receive positive attention.   


Of course, the THINGS children and adults lie about are different. For instance, kids lie about not having broken their parents’ rules or not having disregarded  their parents’ wishes. Adults lie about not having broken laws and not having done things that society regards with disdain. 


Researchers report that repeatedly, in surveys done, parents have rated honesty as the trait they most wanted in their children. They rated honesty above self confidence or good judgment.  This being so, parents are greatly upset when they find that their child has lied to them.



The parent feels betrayed and disrespected and often focuses on that instead of looking for the reason the child lied.  Parents should talk with their children,  as early as possible, regarding   the many reasons why it is important to be honest.  And as the child gets older instead of giving the lecture, it is more effective if the parent asks their child to tell them why it is important to be honest.  In the process of responding with this information, the “no lying” value is reinforced in the child’s mind. 


Another ineffective response to a child lying that parents often use is to play the detective and produce all the evidence they  have to prove that the child is lying.  Even when caught  in the act of a specific misbehavior some children will continue to deny that they did what the parent  actually saw.  That kind of a response from a child usually enrages the parent and the parent never gets to the discussion about the  misbehavior.


For example, if a child lies about having done his/her homework and all of the time is spent discussing the lying, the parent doesn’t find out why the homework hasn’t been done.  The child may need to have some tutoring or the consequence for not doing the homework may need to be changed. 


If a child is lying to classmates about things he/she has achieved, important people the family knows or adventures he/she has experienced, the child may have a low self esteem problem.  Again it would be more important to focus on working to improve the child’s self esteem, than to focus on the child’s lies per se.


In longitudinal studies of children’s lying, a majority of 6 year olds who frequently lie have it socialized out of them by age 7. 


However, another study looking at teens’ lying noted that as children entered their teen years and were trying to gradually gain their independence  by  pushing against their parents’ rules, they lied about a number of insignificant things. The teens reported lying to their parents  about : how they spent their allowance, if they started dating,  what clothes they put on away from the house, what movie they went to and with whom they attended the movie .


Parents, who find their teens lying, again, need to look at the reasons their teen is lying. Once that is determined  parents should address those issues either with more severe consequences or with a teen/parent  discussion looking at expanding the day to day living style choices a teen is capable of making.


Each incidence of lying should be examined independent of others.  Any lying event that involves danger to self or others would, of course, focus first on getting the truth and then looking at the reason for lying.


Generally, no matter what the age of the child, research showed that children lied less often when rewarded for truth telling.  Fear of punishment didn’t appear to be as effective in reducing the lying behavior as rewarding truth telling was.


Sunday, February 2, 2014

Marijuana and Teens

As the number of states legalize the medical use of marijuana and decriminalize recreational use of marijuana, it has become more and more common for marijuana to be viewed simply as a harmless substance. 
One of the unintended consequences of the changes in the law is that teens who use marijuana on a regular basis use the changes in marijuana laws as proof that they will not experience any ill effects from their regular use of marijuana. They reason “if adults feel the use of marijuana is safe, it must also be safe for us to use.”
There is, clearly, not enough information being distributed to parents of teens about the problems associated with teens’ regular use of marijuana.  And parents of teens often are not aware that the marijuana teens use today is much stronger than the marijuana teens were using 20 years ago. 

According to Susan Weiss, Associate Director for Scientific Affairs at the National Institute for Drug Abuse, pot seized in raids now is 15 percent THC as compared to pot seized in earlier times that was 3 or 4 percent , (tetrahydrocannabinol, is the main mind altering ingredient in marijuana.)    
One of the most serious problems associated with teens who regularly use marijuana that is rarely discussed is amotivational syndrome. The mellow feeling that adults enjoy while using marijuana is what makes teenagers lose interest in studies and productive activities they formerly enjoyed and found  stimulating. Teenagers who are chronic users of marijuana just check out of life during their developmental years when it is most important for them to be involved in life.
Chronic teenage users begin over the long term to feel all activities are better enjoyed while under the influence.  Some lose the ability to enjoy the many small pleasures of life that non users enjoy and take for granted.  
Chronic teenage users don’t set career goals.  They spend their time discussing the funny things their friends did while under the influence, who can provide the best marijuana at the best possible price, and who has the best weekend parties.  
Chronic teenage users don’t learn problem solving skills because they turn to marijuana when they encounter problems.
Chronic teenage users,  who are socially awkward, don’t develop healthy social interacting skills because most of their socializing is done under the influence of marijuana.  And, some chronic teenage  users , as adults, may still interact socially as 13 and 14 year olds because that is the age they stopped developing social skills.
Depressed teenagers who use marijuana to self medicate their depression will over time become more depressed.  
Chronic teenage users’ school grades typically fall over time because the THC stored in their brain negatively impacts their short term memory and their ability to focus in class.
Chronic teenage users party their way through high school doing the bare minimum needed to graduate and don’t realize until after high school graduation how ill equipped they are to succeed in the adult world.  
Only too late, as their classmates who made better choices move forward with their lives, do the chronic users realize that the road they took during the critical high school years has lead them to a dead end.  
It is important that parents of teenagers never take too lightly their teenagers use of marijuana.  

Friday, January 10, 2014

Disciplining Teens - A Skill That Takes Practice and Refining

     Teens need rules and they need the rules to be enforced. Sounds simple doesn't it? But giving teens rules and enforcing those rules is one of the more difficult parenting tasks parents face. First off, teens resent rules and they can argue endlessly for a life with no parental controls. Often, parents' first mistake is to engage in the argument about the need for rules. A better approach is to explain that having rules is a given. What can be negotiable are the kinds of rules and the consequences for rules not followed. Many parents readily dismiss the idea of involving their child in the process of making rules and setting consequences without even trying that method. When a child is fairly emotionally healthy and the parent/child relationship is, for the most part, stable and friendly, the rule/consequence negotiation meeting can be a a valuable starting point.Surprisingly, teens on their own often come up with consequences more harsh than the parents are considering. The critical piece when planning the consequence is that enforcing the consequence isn't going to make life more difficult for the parents than the teen. Inconsistent enforcing of the consequences is what usually weakens the whole system.    Grounding the teen seems to be the most ineffective method of discipline because parents usually set up a grounding consequences right after an unexpected misbehavior. The parents are at the height of their anger at the teen and suggest grounding for a period of time that requires they, themselves having to stay at home much longer that is feasible. The teen learns very little from this process other than their parent usually doesn't follow through on the month or six weeks of grounding.The most effective response when an unexpected misbehavior occurs is for the parent to tell the teen, " I am so angry with you that I don't know what I want the consequence to be. I will tell you in a few hours. "  This approach allows the parent come up with an appropriate consequence that the parent will enforce. Allowing the teen to worry about the consequence for a few hours is a plus. But the parent MUST follow as quickly as possible. The closer the consequence is set up following the misbehavior the better. Also important in the disciplining process is the parents' view of the reason for setting up the consequences. The reason is not punishment. The reason is to teach teens that, for the most part, making poor choices results in unwanted consequences. The other reason for disciplining is to help the teen learn self- control. When done right, when the teen accuses the parent of being mean, the parent doesn't crumble but reminds him/herself that setting reasonable consequences is being a good parent. Not setting consequences is poor parenting.Parents often report that their teen says, "I don't care" when the parent removes a privilege.  Usually, THEY DO CARE. That's why they are telling you they don't care. But it doesn't help for the parent to say, " I know that you really do care. " There are times when a teen really doesn't care. When that happens it can be that the teen is depressed. And sometimes when a teen is depressed it is because the parent has taken away all of the teen's privileges without providing any plan for earning them back.Parents also often say "giving my teens consequences for misbehavior doesn't work; I've tried it." This usually means the parent thinks that letting the teen know in advance what the consequence is will automatically stop the behavior. When the unwanted consequence for misbehavior is first established, the teen will test it at least three times to see if the parent is truly going to follow through with the enforcement of the consequence. Once the teen sees the parent is being consistent in enforcing consequences the unwanted behavior usually stops. Occasionally, the teen may weigh the benefits to him/herself of the misbehavior and then choose the misbehavior. Parents may then have to find a new consequence. Another important tip is to start small with consequences so you can add or intensify as needed. For instance, take away the cell phone for one night in response to one instance of a minor unwanted behavior.  Then when a more serious misbehavior occurs you have the option of taking the phone away for a week or more. Food, shelter, clothing and health care are some of the basics parents are expected to give their child. Most of the other things parents are currently providing for their children are privileges that can be taken away for short periods of time as consequences for misbehavior. It helps when both parents and teens start with this premise in mind.