Brought to you by Anne J. Ford, MSW, LICSW

ADHD affects peer relations, social judgment and behavior choices.  ADHD is the most commonly diagnosed mental health disorder in children today.  5% to 8% of children will be diagnosed with ADHD.  That is 2 children out of every classroom.  It is manifested in impaired development and adaptation, with school adjustment problems and learning difficulties.  There is an increased risk for accidental injury, substance abuse, and driving accidents.
ADHD is diagnosed when parents and caregivers describe symptoms such as difficulties with distraction, sustaining attention, disorganization, easily distracted, forgetful, doesn’t seem to listen, inattention and/or activity symptoms such as fidgets, squirms, difficulty playing quietly, seems driven by a motor, talks excessively, runs about, blurts out answers, difficulty waiting for a turn, impulsive, acts before thinking through, interrupts, and socially intrusive.  The most common intervention for this diagnosis is medication and behavior management training.  These often work to manage the behavior problems of ADHD.  Unfortunately the interpersonal and learning problems are rarely remediated.  This is due to the inability to create monitor emotion, social cues, processing language and responding.

Much like our muscles, nerves and joints need to move together, our brain has separate functions that need to work together in order to function, organize, and learn.  Our brain needs to integrate to work in a balanced and coordinated way.  Our brains are made up of the left side that helps us to think logically and organize our thoughts and the right side that allows us to experience emotions and the ability to read non-verbal cues, the reptile brain which allows us to act instinctually for survival skills and in making split second decisions.  The mammal brain allows us to connect and relate to others.  This integration of the areas of the brain allows us to survive and thrive.  When our brains are not integrated well enough, common functioning challenges seem chaotic and confusing with tantrums, meltdowns and aggression.

New technology has confirmed that our developing brain has plasticity and is moldable, that it can change through our lifespan, not just in childhood.  New experiences, learning and therapy can actually change the structure of the brain.  Therapeutic intervention may prevent or reduce symptoms, severity and impairment of ADHD by changing the neuronal architecture of the brain.  According to Karen Bierman at Penn State University, with the help of therapy there has been a positive response for remediating interpersonal difficulties, improve behavior management, and learning difficulties.

Instead of supporting the handicap through environmental interventions, therapy actually addresses brain development differently so separate parts of the brain become better connected and work together.  This is done through a multi-modal approach of redefining how language is used to help the child think through the process of the promotion of executive skill functioning through therapy, practicing pacing skills to thwart impulsivity and increase social judgment, empathy skills.

Brought to you by Anne J. Ford, MSW, LICSW

If you’re a mom with ADHD who is struggling to raise a child, or    children, with ADHD, it’s time to take heart. Here are ways to ease the journey of parents who share a diagnosis with their kids.  Several authorities share similar advice:

• Keep your cool when clueless people tell you to “just stay calm. This is an extremely challenging task and mom needs to find some stress reducing ways such as yoga, walking, friend’s time consistently.
• Monitor yourself and self correct when needed. Sleep, exercise and eating habits can help or put you into the “upset zone.”
• Medication is not magic. Meds most likely will not solve all of your problems, they may reduce hyperactivity and inattention, they do little to lessen parenting difficulties. Behavioral therapy among others is needed to improve social interaction including family relationships.
• Hold “fire drills’ with your kids. Handle conflict at a no conflict time. Talk about what you all can do next time you aren’t calm. Then act it out, go to time out, use problem solving strategies.
• Avoid finger pointing. Don’t blame everything that goes wrong on one family member. Family members influence each other, it’s best to acknowledge the ways which everyone contributes to a conflict, everyone learns.
• When you find you’re in a power struggle, back out. No more destructive battles, find a way to discuss the limit setting at a calmer time.
• Don’t sweat the small stuff. Parents consider which power struggles should be pursued, as matters of safety and which should be let go for the sake of the family’s sanity.
• Manage bad behavior. Sometimes a parent who shares a diagnosis will identify so closely with a child that she or he will fail to set appropriate limits. There’s a fine line between explanation and excuse, be specific.
• Outsource what ever you can. Find out if your school offers help with homework or if your child has accommodations, request a lighter homework load. If you can afford it, hire a tutor.
• Maintain your SENSE OF HUMOR.

ADHD never goes away, but you can make improvements by managing
symptoms and learning new therapies that can increase skills for
processing, pacing and improve self control.

Adapted from Kathleen Nadeau Ph.D and Andrea Chronis-Tuscano Ph.D
article, "The Double Whammy Game Plan."

Brought to you by Harriet Kohen, LICSW

I have learned over the years that kids have plenty to say.  I thought you would enjoy this article by Jeff Opdyke in the Wall Street Journal.

By JEFF D. OPDYKE

Wall Street Journal  November 28, 2010I picked up my 14-year-old son from school two weeks ago. I smiled at him. He laughed...and then he got mad.
That morning, an orthodontist had slapped braces on my teeth. I smiled to show my son, who is just weeks away from getting his braces off. While at first he thought it was funny that Dad had braces too, he quickly realized I'd gotten the clear braces; his are full-metal jacket.

"How much extra was that?" he asked. I told him $500. "Why didn't I get those? Why do I have to get the ugly braces and you get the ones that don't look as bad?" He was miffed, and raised the topic again with his mom that night.

Later, as I thought more about it, I started to realize that something is wrong with this picture. Why does my son believe -- no, assume -- that he and I should spend the same amount of money on our respective braces.

The answer, I also realized, is because of the way I've raised him, and it was yet another illustration of something I (and readers) have mentioned before: the blurring of the lines between so many parents and children. Many kids these days see themselves as fully empowered members of the family, with opinions that carry just as much weight as their parents' opinions do.

That's not always bad. But we parents today have gone overboard. We have inadvertently created kids who think they have the power to dictate what happens in the family -- from where we go to eat to where we vacation to the kinds of braces we each deserve.  It's time, I would argue, to take back control.
Most parents my age -- I'll be 45 in January -- grew up in a time when our choices were limited to one: Whatever Mom and Dad said you were doing, you did.                                                                If my grandparents, who raised me in South Louisiana, said that we were going to visit my uncle in Mississippi over the weekend, I had no other option but to go to Mississippi, no matter how much I didn't want to. If they said Friday night dinner was at the Piccadilly restaurant, I couldn't counter with some other restaurant I might want to eat at instead. It wouldn't have dawned on me to even try.
 
But that's not how it always goes today.

Moms and dads today often play the role of friend instead of parent. Many of us, no doubt, want to avoid giving our kids the sense of powerlessness, and the distance, we might have felt with our own parents. But in doing so, we've inadvertently given our kids a sense of power that we may one day come to rue.

A friend of mine, for example, says that his teenage daughter thinks it is "monumentally unfair that her computer isn't quite as powerful as the one I have for work." And like me, he realizes he brought this on himself.

"Too many times I've asked her for input in decisions she should have no say in," he says. "I should just get her a computer rather than ask, 'Is this one good enough?' There is a line between getting input and letting her dictate, and at times, I've not drawn that line sharply enough."

To be clear, this isn't about kids who are bratty, obnoxious or harbor a sense of entitlement. These aren't bad kids. It's just that many of today's generation of youngsters have grown up in a world where their opinions matter. A lot.

The question now is what do we do with the power-hungry monsters we have created? How do we fix them?

Many parents, I know, will fume about this column. They will insist that kids should never be allowed to define expectations -- particularly when it comes to how the family spends money. Mom and Dad make those decisions, no questions asked. The problem isn't one of balance, they'll say. Kids are kids and parents are parents, and you shouldn't mix the two.

I agree...up to a point. Despite my lamenting in this column, I don't think we parents should impose every one of our choices on our children without their input. Kids need to feel like they have a voice, and that the voice is heard. Eventually, it will help them learn how to make smart decisions -- and the consequences of making not-so-smart ones.

At the same time, it isn't good for them to feel in control, either. They don't want all that power, even if they think they do. They want the security of somebody else making decisions. They need to know that parents make the rules.

That's the balance I need to find, and that has too often been lacking in my house. To offer a simple example: If I'm craving Greek for dinner and my son or daughter isn't, I want them to express that; it's a lesson in learning to defend your desires and not to accept what everyone else around you is pushing.

That doesn't mean I'll change my mind. And it doesn't mean we won't eat Greek that night. But, then again, I might say to one of my kids, "OK; your call tonight. You get to choose."

For those of us who have gone too far, it's important to scale back the authority we've given our children. But not all the way.

The decisions kids make, for instance, might be relatively rare events that they come to see as "special." Maybe it's the opportunity once a month to have complete control over the family's Friday night plans -- the restaurant you go to, the movie you see. Maybe it's giving your kids three vacation options to choose from. Maybe it's regularly letting them voice their opinions about anything they want, with no guarantees that Mom and Dad will agree with them. But we'll listen.

That's what I have started to do. Before it's too late, I am determined to revoke the authority I have too often ceded to my kids. If I want to spend $500 extra on clear braces that my son didn't get...hey, it's my money and my choice.

Not his.

Brought to you by Harriet Kohen, LICSW

I often get asked for a list of easy communication “Do’s and Don’ts” with teenagers.  If you only have to remember a few things while communicating with your teen, I like these top ten suggestions from Vanessa Van Petten’s Radical Parenting web site.  Some of these “Do’s and Don’ts” are harder in practice than theory, but they often save the day.  Typically, the hardest ones to implement are the ones we parents need to work on the most!  Want face to face help with your teen?  Give Harriet Kohen a call at Partners in Healing of Minneapolis at 763-546-5797. 

1. Never talk about your teen in front of them as if they are not there.

2. Don’t let your teen place objects between you.  This creates emotional barriers—the remote control is quite popular.

3. If your teen goes into ‘whine’ mode, do not respond until they insist on taking the ‘whine’ out of their tone.

4. Never embarrass your teen to be funny.  This only creates barriers between you and it does not ‘give them thick skin.’

5. If you are in an argument, try changing locations–those three seconds provide space to calm down and reset.

6. Don’t play ‘what if’ with your teen or yourself; this will only end in a battle of logic.

7. Don’t fall into the ‘I’ll do it later’ trap.  We all know they won’t do it later and you will be disappointed.

8. If you want your teen to break a rule, say because ‘I said so.’

9. Always start discussion with what you agree on.  This puts you both on the same page and makes it easier when they have to compromise later.

10. If you feel like you might say something you do not mean, walk away.

Source:  www.radicalparenting.com (August, 2010)

Brought to you by Harriet Kohen, MSW and Lois Fischer, MA, LMFT

Yesterday we told about Julie Scelfo's New York Times article entitled "Your Brain on Computers:  The Risks of Parenting While Plugged In."  Here is Part II.  Too much texting?  Trouble with your "Crackberry"?  Need help with your family relationships?  Schedule with us at 763-546-5797.  Use your HSA (Health Savings Account) and get what you and your family need.

"Your Brain on Computer:  The Risks of Parenting While Plugged In" (Part II)

NOT ALL child-development experts think smartphone and laptop use by parents is necessarily a bad thing, of course. Parents have always had to divide their attention, and researchers point out that there’s a difference between quantity and quality when it comes to conversations between parents and children.

“It sort of comes back to quality time, and distracted time is not high-quality time, whether parents are checking the newspaper or their BlackBerry,” said Frederick J. Zimmerman, a professor at the University of California, Los Angeles, School of Public Health who has studied how television can distract parents. He also noted that smartphones and laptops may enable some parents to spend more time at home, which may, in turn, result in more, rather than less, quality time overall.

There is little research on how parents’ constant use of such technology affects children, but experts say there is no question that engaged parenting — talking and explaining things to children, and responding to their questions — remains the bedrock of early childhood learning.Betty Hart and Todd R. Risley’s landmark 1995 book, “Meaningful Differences in the Everyday Experience of Young American Children,” shows that parents who supply a language-rich environment for their children help them develop a wide vocabulary, and that helps them learn to read.

The book connects language use at home with socioeconomic status. According to its findings, children in higher socioeconomic homes hear an average of 2,153 words an hour, whereas those in working-class households hear only about 1,251; children in the study whose parents were on welfare heard an average of 616 words an hour. The question is: Will devices like smartphones change that? Smartphone users tend to have higher incomes; research from the Nielsen Company shows that they are twice as likely to make more than $100,000 a year than the average mobile subscriber. If increased use of technology encroaches on the time that well-to-do families spend communicating with their children, some could become the victims of successes originally thought to help them.

Dr. Hart, who is now professor emeritus at the University of Kansas Life Span Institute, said that more research is needed to find out whether the constant use of smartphones and other technology is interfering with parent-child communications. But she expressed hope that more parents would consider how their use of electronic devices might be limiting their ability to meet their children’s needs.

Part of the reason the children in affluent homes she studied developed larger vocabularies by the time they were 3 is that “parents are holding kids, the kids are on their lap while the parent is reading a book,” Dr. Hart said. “It is important for parents to know when they’re talking to kids, they’re transferring affection as well as words. When you talk to people, there’s always an implicit message, ‘I like you,’ or ‘I don’t like you.’ ”

Meredith Sinclair, a mother and blogger in Wilmette, Ill., said she had no idea how what she calls her “addiction to e-mail and social media Web sites” was bothering her children until she established an e-mail and Internet ban between 4 and 8 p.m., and her children responded with glee. “When I told them, my 12-year-old, Maxwell, was like, ‘Yes!’ ” Ms. Sinclair said.

“You can’t really do both,” she added. “If I’m at all connected, it’s too tempting. I need to make a distinct choice.”

Brought to you by Harriet Kohen, MSW and Lois Fischer, MA, LMFT

How are smart phones and computers affecting your family relationships? There is much food for thought in Julie Scelfo's terrific article in the New York Times (June 9, 2010) entitled "Your Brain on Computers: The Risks of Parenting While Plugged In." Need help with your family relationships? We love working with children and teens.  Schedule with Harriet Kohen and Lois Fischer at 763-546-5797.  Use your HSA (Health Savings Account) and get what you and your family need.

"Your Brain on Computers: The Risks of Parenting While Plugged In" 

WHILE waiting for an elevator at the Fair Oaks Mall near her home in Virginia recently, Janice Im, who works in early-childhood development, witnessed a troubling incident between a young boy and his mother.

The boy, who Ms. Im estimates was about 2 1/2 years old, made repeated attempts to talk to his mother, but she wouldn’t look up from her BlackBerry. “He’s like: ‘Mama? Mama? Mama?’ ” Ms. Im recalled. “And then he starts tapping her leg. And she goes: ‘Just wait a second. Just wait a second.’ ”

Finally, he was so frustrated, Ms. Im said, that “he goes, ‘Ahhh!’ and tries to bite her leg.”

Much of the concern about cellphones and instant messaging and Twitter has been focused on how children who incessantly use the technology are affected by it. But parents’ use of such technology — and its effect on their offspring — is now becoming an equal source of concern to some child-development researchers.

Sherry Turkle, director of the Massachusetts Institute of Technology Initiative on Technology and Self, has been studying how parental use of technology affects children and young adults. After five years and 300 interviews, she has found that feelings of hurt, jealousy and competition are widespread. Her findings will be published in “Alone Together” early next year by Basic Books.

In her studies, Dr. Turkle said, “Over and over, kids raised the same three examples of feeling hurt and not wanting to show it when their mom or dad would be on their devices instead of paying attention to them: at meals, during pickup after either school or an extracurricular activity, and during sports events.”

Dr. Turkle said that she recognizes the pressure adults feel to make themselves constantly available for work, but added that she believes there is a greater force compelling them to keep checking the screen.

“There’s something that’s so engrossing about the kind of interactions people do with screens that they wall out the world,” she said. “I’ve talked to children who try to get their parents to stop texting while driving and they get resistance, ‘Oh, just one, just one more quick one, honey.’ It’s like ‘one more drink.’ ”

Laura Scott Wade, the director of ethics for a national medical organization in Chicago, said that six months ago her son, Lincoln, then 3 1/2, got so tired of her promises to get off the computer in “just one more minute” that he resorted to the kind of tactic parents typically use.

“He makes me set the timer on the microwave,” Ms. Wade said. “And when it dings he’ll say, ‘Come on,’ and he’ll say, ‘Don’t bring your phone.’ ”

     (Authored by Harriet Kohen, LICSW)

I recently learned about an amazing web site for parents written by teens that I’ve shared with a number of parents.  Vanessa Van Petten, along with teen writers, created a blog called Radical Parenting that provides perspectives and advice about a variety of topics that affect teen-parent communication.  I found this material full of helpful and reasonable information, and loaded with communication techniques. Topics addressed include how to convey worry, how to convey love, and getting tweens and teens to listen. Radical Parenting also addresses computer use, sex, drugs and rock and roll too, along with advice about the “hard stuff .” The blog is highly readable and pertinent to modern family communication. The web address is  www.radicalparenting.com. You can access the blog from the web site. You can also sign up to receive their informative newsletter along with an e-book download, How To Communicate With Tweens and Teens 101. Let me know what you think at 763-546-5797. Need a therapist for your family? I'm glad to help. 

    Authored by Harriet Kohen and Lois Fisher

At graduation time, it reminds us of those we love...and those we seldom see, often due to a painful divorce.  This article from the New York Times reminds us to help our children through big life transitions, no matter their age.  Let us help your family with transitions, as well as the issues that affect our every day.  Just give Harriet Kohen and Lois Fischer a call to schedule at 763-546-5797. 

When the Ties That Bind Unravel

                                                                            Stuart Bradford

Therapists for years have listened to patients blame parents for their problems. Now there is growing interest in the other side of the story: What about the suffering of parents who are estranged from their adult children?

While there are no official tallies of parents whose adult children have cut them off, there is no shortage of headlines. The Olympic gold medal skier Lindsey Vonn reportedly hasn’t spoken to her father in at least four years. The actor Jon Voight and his daughter, Angelina Jolie, were photographed together in February for the first time since they were estranged in 2002.

A number of Web sites and online chat rooms are devoted to the issue, with heartbreaking tales of children who refuse their parents’ phone calls and e-mail and won’t let them see grandchildren. Some parents seek grief counseling, while others fall into depression and even contemplate suicide.

Joshua Coleman, a San Francisco psychologist who is an expert on parental estrangement, says it appears to be growing more and more common, even in families who haven’t experienced obvious cruelty or traumas like abuse and addiction. Instead, parents often report that a once-close relationship has deteriorated after a conflict over money, a boyfriend or built-up resentments about a parent’s divorce or remarriage.

“We live in a culture that assumes if there is an estrangement, the parents must have done something really terrible,” said Dr. Coleman, whose book “When Parents Hurt” (William Morrow, 2007) focuses on estrangement. “But this is not a story of adult children cutting off parents who made egregious mistakes. It’s about parents who were good parents, who made mistakes that were certainly within normal limits.”

Dr. Coleman himself experienced several years of estrangement with his adult daughter, with whom he has reconciled. Mending the relationship took time and a persistent effort by Dr. Coleman to stay in contact. It also meant listening to his daughter’s complaints and accepting responsibility for his mistakes. “I tried to really get what her feelings were and tried to make amends and repair,” he said. “Over the course of several years, it came back slowly.”

Not every parent is so successful. Debby Kintner of Somerville, Tenn., sought grief counseling after her adult daughter, and only child, ended their relationship. “It hit me like a freight train,” she said. “I sit down and comb through my memories and try to figure out which day was it that it went wrong. I don’t know.”

Ms. Kintner talks of life as a single parent, raising an honor student who insisted her mother accompany her on a class trip to London, a college student who made frequent calls and visits home. Things changed after her daughter began an on-again, off-again relationship with a boyfriend and moved back home after becoming pregnant. Arguments about her daughter’s decision to move in with the man and Ms. Kintner’s refusal to give her daughter a car eventually led to estrangement. She now has no contact with her daughter or three grandchildren.

“I knew parents and children had fights, but there was enough love to come back together,” Ms. Kintner said. “This is your mother who gave you a nice life and loved you.’ “

Judith, a mother in Augusta, Ga., who asked that her last name not be used, tells of a loving, creative daughter who experienced a turbulent adolescence. At college graduation, the parents were shocked when their daughter unleashed an angry tirade about her childhood. Later, the daughter asked for financial help paying for an Ivy League graduate school. The parents agreed, but a visit to see her on the East Coast was marred by another round of harsh words and accusations. They withdrew their financial support and returned home.

“I’ve done a lot of crying,” said Judith, who has sought therapy to cope. “I’m very depressed. All the holidays are sad, and we don’t have any closure on this. She was so wanted. She was so loved. She still is loved. We want her in our life.”

Dr. Coleman says he believes parental estrangement is a “silent epidemic,” because many parents are ashamed to admit they’ve lost contact with their children.

Often, he said, parents in these situations give up too soon. He advises them to continue weekly letters, e-mail messages or phone calls even when they are rejected, and to be generous in taking responsibility for their mistakes — even if they did not seem like mistakes at the time.

After all, he went on, parents and children have very different perspectives. “It’s possible for a parent to feel like they were doing something out of love,” he said, “but it didn’t feel like love to that child.”

Friends, other family members and therapists can often help a parent cope with the loss of an estranged child. So can patience: reconciliation usually takes many conversations, not just one.

“When I was going through this, it was a gray cloud, a nightmare,” Dr. Coleman said. “Don’t just assume if your child is rejecting you that that’s the end of the conversation. Parents have to be on a campaign to let the child know that they’re in it for the long haul.”

Authored by Harriet Kohen, MSW, LICSW

Becoming a first time parent is challenging. Leaning to care about your baby and develop your parenting skills often means putting the baby’s needs first and your needs second. There is an important biological and psychological reason for that.  You are your baby’s most important role model.
Why is attachment important to babies and their parents?  Attachment is a love relationship between parents and their children that is developmental and relational and grows over time. Positive  attachment provides nurturing and a sense of safety. It also allows the baby to adapt to her environment (the family) and influences her future functioning.  

Development unfolds in an orderly way as babies grow into to toddlers and then into school-aged children and then into teenagers.  What we know about typical development is that children growing up in families where their developmental needs to be protected, fed and comforted are met; develop physical, emotional and healthy ways of interacting and problem solving. And of course the range of normal behavior is broad. 

This interaction between a baby’s primary caregiver organizes and helps to build babies experience. Babies are learning all the time. They watch and repeat what they see and hear. How does a baby learn to smile? You teach the baby how to smile when you show your love and joy with a smile. They learn to smile back at you.  This is called mirroring. It’s one of the primary ways infants learn.

Recently Susan K. Schultz, PhD, Carol F. Siegel, PhD, and Scott D. Harmon, LICSW led a workshop about Infant Mental Health. They presented research and case studies exploring how the quality of the relationship between a baby and a parent is protective and reduces risk for baby as she grows into a young child. The parent who is the primary caregiver can be the   mom, the dad or some other constant presence. The goal of attachment behavior is for the parent to get in sync with the baby and meet it’s needs so it feels secure, safe and willing to explore their environment.

Sure there are times when a parent can’t read or figure out what their baby needs and becomes exasperated. Babies do too. But when at baby becomes dysregulated, i.e., out of sorts by crying too much, or becoming fearful, the role of the parent is to respond positively to the baby and to teach the baby how to regulate that arousal. For example, you may wonder is the baby crying because it’s hungry, tired, wet, bored or uncomfortable? It does not take long for a parent to learn to know the difference between their baby’s cries and respond. Once the baby’s need is met, they shift to calmer behavior and begin to learn the difference between feeling agitated or excited and calm.

Attachment helps to organize behavior. The more organized and consistent a parent is, the more the baby knows what to expect. That baby with strong emotional support gradually learns to take developmental risks such as learning to stand and walk because if they fall down, they will be comforted and given the opportunity to do it again.  They learn to trust. The more disorganized and inconsistent a parent is, the less the baby trusts their environment, and fear and mistrust can develop. Children may sometimes withdraw from their parents if they learn through experience that nobody is coming to feed or comfort them. 

So if you’re a first time parent and are worried about caring for your baby. There are a number of baby books and resources to read that describe typical baby development. You can check with trusted friends, parents, and your pediatrician about your baby’s growth and development. You will figure out how to give yourself some of that me time so essential to become a good enough parent.