05.08.12 4:33 PM ET
Cheat Sheet: 5 Tips for Kids’ Mental Health
For National Children’s Health Awareness Week, adolescent psychiatrist Dr. Harold Koplewicz breaks down five things every parent should know. Plus, Koplewicz on why parents shouldn’t be blamed for medicating their kids.
1. The War Over ADHD Meds
Are too many kids being medicated for ADHD—a disorder that some say isn't even real? Parents are often told that they're overreacting if they put kids on medication, and recently there have been charges that the meds don't really work, or at least not long enough to really help kids. But an examination of the research shows that for children who have been carefully diagnosed—that is, they are chronically more impulsive, hyperactive, and inattentive than typical children—stimulants like Ritalin and Adderall are clearly effective in reducing symptoms. There is less agreement, however, on whether the effectiveness of stimulants wears off over time: some studies and some clinicians report the need to gradually increase dosage to get the same effect; others don't. And there are no studies longer than two years—ethics boards just aren’t likely to put hundreds of struggling kids on placebos for an extended period.
2. Giving Parents Better Tools
When kids are acting up at the supermarket, any parent will tell you, it's other parents who are the first to call bad parenting. Still, in a recent survey more than two thirds of parents said their biggest worry about their own children is discipline and behavior. That's why behavioral psychologists are working hard to turn the techniques that have been used successfully in therapy into tools that parents can use at home. Programs like parent-child interaction therapy give parents step-by-step instruction in how to maximize the kind of behavior they want to encourage and minimize the kind they'd like to see less of. The results: parents find themselves calmer and more confident authority figures, and kids who seemed out of control develop the skills they need to regulate their own behavior. What works at home spills over into school, too, happy parents report, calling it “life changing.”
3. College Students With Autism
There is a wave of young people on the autism spectrum who are headed off to college after high school. These are bright if socially awkward children who have been doing well academically, with the support of their families and often with supports at school. But they often lack the organizational skills it takes to live independently and stay on top of the work, which in turn causes crippling anxiety. For kids who are very verbal and whose autism is not obvious, says one activist, herself on the spectrum, the risk of being overwhelmed is great. “We're dysregulated more easily than people with a non-autistic brain." Kids on the spectrum need to be able to spend more time in school “without it being prohibitively expensive to our families,” says one Vassar junior who’s taking a semester off and earning a few credits at a community college to keep her course load more manageable when she goes back.
4. 'Mindful' Kids Are Calmer Kids
Yoga for school kids? Not quite, but meditation-based "mindfulness" is being taught to children all over, and it's helping them learn to calm down, pay attention, and fight stress. It's especially useful for kids who have trouble regulating their own behavior, studies show, including youngsters with ADHD, anxiety, depression, and autism. Breathing exercises are used to focus on the current moment giving kids distance on thoughts and impulses that are disturbing them, and some teachers say it's making their classrooms more manageable and students more able to learn. Therapists say it's useful for the emotional roller coaster of adolescence, but kids much younger are getting into it too, including one second grader who calmly told her older sister, who was having a meltdown, “You need to take a deep breath and clear your pre-frontal cortex. You'll feel much better.”
5. Fighting Anxiety With Exposure
Parents of anxious kids naturally try to protect them from the things they fear; no one wants to see a child suffer. But avoidance feeds anxiety, and the state-of-the-art treatment for obsessive-compulsive disorder and other anxiety disorders in children is something called “exposure with response prevention.” It involves exposing children to the things that trigger their anxiety incrementally, in a safe, controlled setting, and helping them develop tolerance without performing their compulsive rituals. Parents are enlisted to help them practice at home until the OCD, which Dr. Jerry Bubrick at the Child Mind Institute calls “a bully in their brain,” is no longer giving orders, and they are in charge again.