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“WHEN IMPULSES RULE a CHILD’S LIFE | Psychology Today

WHEN IMPULSES RULE a CHILD’S LIFE

By David Lewis , Ph.D. on December 27, 2013 – 3:50am

Billy, an impulsive 11-year-old, is viewed by his teachers as somewhat lazy, easily distracted and lacking in motivation.

His parents, convinced their son’s poor performance was due to a ‘mental’ problem, insisted he be as tested by the school’s psychologist. When she reported Billy was a perfectly normal little boy they refused to accept her diagnosis. They went to three further psychologists all of whom confirmed their colleague’s original findings. Still dissatisfied they sent him to a yet another specialist who finally provided the diagnosis they sought. Billy, he said, was suffering from Attention Deficit Hyperactive Disorder (ADHD). Given the appropriate medication their son could well turn into a straight A student.

“We always knew it,” they told his teachers triumphantly. “Our son is not lazy – he’s sick.”

They are far from unusual in this desire to explain away behaviour which, even a decade ago, might have been viewed as a normal part of growing up as a medical condition for which a cure must be found.

In the US, ADHD is now the second most frequent long-term diagnosis made in children, beaten only narrowly by asthma. Data from the Center for Disease Control and Prevention indicate it has been diagnosed in up to 15% of high school-age children and that the number of youngsters being medicated for the disorder has risen from 600,000 in 1990 to 3.5 million today. By contrast, world-wide, ADHD affects only around 5% of children, the majority boys. (1)

It is, of course, essential that children with a genuine illness are speedily diagnosed and effectively treated. Medication, in such cases, is often an essential first step on the road to recovery.

The trouble is that between obviously healthy and manifestly sick youngsters there is a grey area which is growing in size with every passing year. Since, in the absence of pathology, there are at present no tests or scans that can detect mental illness, diagnosis tends to be subjective. What one psychologist considers perfectly ‘normal’, another may view as highly abnormal.

In a recent interview with the New York Times Dr Keith Conners, a psychologist and professor emeritus at Duke University, who for more than 50 years has led the fight to legitimise the disorder, called this increase:

“A national disaster of dangerous proportions…a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.” (3)

The most widely used form of treatment is to use drugs, such as methylphenidate atomoxetine, and dexamfetamine. Unfortunately, around one in five ADHD sufferers fail to respond to drugs (4) while in many other cases the response is only partial. Furthermore, all drugs have side effects, can also be habit forming and open to abuse. Long-term follow-ups have found that when children stopped taking the drug their clinical symptoms of ADHD reappeared.

Problems such as these have led some therapists, especially in the US, to start using a form of treatment known as EEG-Neurofeedback training.

This involves teaching sufferers how to control their ‘brain waves’ by playing computer games via sensors attached to their head. (5) The results appear promising, with improvements being found in around 40 percent of cases at six month follow-up.

In a recent study in my laboratory* two teenage boys played a computer game involving a race between a red and a blue caterpillar. Thin wires ran from electrodes pasted to their scalps to a control box. This detects electrical activity in their brains and uses these ‘brain waves’ to move the caterpillars across the screen.

Mark, aged 13 has been diagnosed with ADHD his friend, 14-year-old Ryan exhibits no such symptoms. During the game, Ryan’s red caterpillar speeds quickly along the track as he reduces his output of slow moving ‘theta waves’ while simultaneously increasing faster moving ‘beta waves’. Mark’s brains produces higher levels of theta and lower levels of beta waves his blue caterpillar barely moves off the start line.

Over a period of time, however, Mark trains himself to reduce his theta and boost his beta waves. In doing so he learns to control his impulsive behaviours.

While researching for my new book, Impulse, I came across several examples of behaviour which our forefathers would have shrugged off but which present-day parents see as requiring medical intervention. Given the lifestyle of many youngsters these days this may not be so surprising.

Many youngsters are discouraged from engaging in activities, such as exploring, getting into and out of scrapes, climbing trees and falling over, that earlier generations accepted as a normal part of childhood down. Even the amount of time they have for exercise is so constrained these days, especially for urban children, by parental concerns for their safety. Some children may be exhibiting the symptoms of hyperactivity simply because they’re not getting enough physically demanding exercise!

Taking risks and learning from the consequences of their mistakes is an essential part of growing up and developing independence.

The teenage years, especially, are the most intense and exciting of a child’s life. They’ll be unhappy, do silly things, take reckless decisions and make foolish misjudgements of people and situations.

But if they behave impulsively and fall flat on their faces from time to time, this doesn’t mean they need a diagnosis or a pill. It just means they’re being kids.

* Mindlab International is purely a research laboratory and does not offer any neurofeedback training. There are, however, many practitioners in both the USA and UK

References

(1) Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., Rohde L. A., (2007) The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis. American Journal of Psychiatry, 164(6), 942–948.

(2) Faraone, S. V., Biederman, J., Mick, E., (2006) The Age-Dependent Decline of Attention Deficit Hyperactivity Disorder: A Meta-Analysis of Follow-Up Studies. Psychological Medicine, 36(2), 159–165.

(3) Schwarz, A. (2013) The Selling of Attention Deficit Disorder, New York Times, Dec 14

(4) Charach, A., Figueroa, M., Chen, S., Ickowicz, A., & Schachar, R. (2006) Stimulant treatment over 5 years: effects on growth. Journal of American Academic Child Adolescent Psychiatry, 45: 415–421.

(5) Lansbergen, M. M., van-Dongen-Boomsma, M., Buitelaar, J. K., Slaats-Willemse, D., (2010) ADHD and EEG-Neurofeedback: A Double-Blind Randomized Placebo-Controlled Feasibility Study. Journal of Neural Transmission, 118(2), 275-284

“WHEN IMPULSES RULE a CHILD’S LIFE | Psychology Today

What is Theraplay?

You may have heard of “play therapy” for children but  have your ever heard of TheraPlay? This pioneering approach to attachment-based, family therapy is one that I have been practicing for many years and still find it one of the most practical approaches to working with families, particularly children who have endured trauma. 

Theraplay is a child and family therapy for building and enhancing attachment, self-esteem, trust in others, and joyful engagement. It is based on the natural patterns of playful, healthy interaction between parent and child and is personal, physical, and fun. Theraplay interactions focus on four essential qualities found in parent-child relationships: Structure, Engagement, Nurture, and Challenge. Theraplay sessions create an active, emotional connection between the child and parent or caregiver, resulting in a changed view of the self as worthy and lovable and of relationships as positive and rewarding.

In treatment, the Theraplay therapist guides the parent and child through playful, fun games, developmentally challenging activities, and tender, nurturing activities. The very act of engaging each other in this way helps the parent regulate the child’s behavior and communicate love, joy, and safety to the child. It helps the child feel secure, cared for, connected and worthy.

We call this “building relationships from the inside out.””

Identifying Teens at Risk for PTSD:

Many teens are exposed to emotionally traumatic events, putting them at risk for developing post-traumatic stress disorder (PTSD).

A new study found online in the Journal of the American Academy of Child & Adolescent Psychiatry helps clinicians target those who are most vulnerable to developing PTSD.

Researchers from Boston Children’s Hospital analyzed data on 6,483 teen–parent pairs from the National Comorbidity Survey Replication, a survey of the prevalence and correlates of mental disorders in the United States.

They discovered that 61 percent of the teens (ages 13 to 17) had been exposed to at least one potentially traumatic event in their lifetime, including interpersonal violence (such as rape, physical abuse or witnessing domestic violence), injuries, natural disasters and the death of a close friend or family member.

Nineteen percent had experienced three or more such events.

Investigators determined the risk factors associated most strongly with trauma exposure included:

  • Lack of both biological parents in the home;
  • Pre-existing mental disorders, particularly behavioral disorders such as attention-deficit hyperactivity disorder (ADHD) and oppositional-defiant disorder.

Of all teens exposed to trauma, 4.7 percent had experienced PTSD under DSM-IV diagnostic criteria.

Risk factors for PTSD included:

  • Female gender: Of the total sample, girls had a lifetime prevalence of PTSD of 7.3 percent, and boys 2.2 percent;
  • Events involving interpersonal violence: the lifetime prevalence of PTSD was 39 percent for teens who had been raped and 25 percent for those physically abused by a caregiver;
  • Underlying anxiety and mood disorders (also a risk factor for exposure).

Recovery from PTSD was complicated if the teen:

  • Had underlying bipolar disorder;
  • Was exposed to an additional traumatic event;
  • Lived in poverty;
  • Was a U.S. native.

Need help for your teenager and live in the Redding, California area? Ron Huxley, founder of the Parenting Toolbox, is open to helping families through his private practice starting September 2013. If you prefer a consultation (not therapy) via Skype or email, click on the “Parenting Answers” link here or contact Ron at rehuxley@gmail.com.

Firesetting: Why kids do it and how parents can manage it

For parents, the dangers of fire are so apparent that the sight of a child anywhere near a flame is enough to send them scrambling. And fortunately, most kids are afraid of fire and understand that it can hurt them and others.

But it’s not unusual for kids to be curious about fire, too. After all, we enjoy campfires and singing over birthday candles. That’s why it’s so important to educate kids about the dangers of fire and to keep them away from matches, lighters, and other fire-starting tools.

Even with the best efforts from parents, kids might play with fire. Most of the time this can be handled by explaining the dangers and setting clear ground rules and consequences for not following them.

But sometimes kids seem to be especially preoccupied with fire and repeatedly attempt to set things on fire, which can be a sign of emotional and behavioral issues that require professional help.

Why Kids Set Fires

Young children who set fires usually do so out of curiosity or accidentally while playing with fire, matches, or lighters, and don’t know how dangerous fire can be. During the preschool years, fire is just another part of the world they’re exploring. Unfortunately, these fires tend to be the most deadly because kids in that age group don’t know how to respond to a fire, and may set it in a small, enclosed space, such as a closet.

As kids get a little older, they might be fascinated with fire. It’s fairly common for them to do things like light paper with matches, set things on fire using a magnifying glass, or play with candles or other things that have a flame. That’s usually not a cause for concern.

But if a school-age child deliberately sets fires, even after being reprimanded or punished, a parent needs to talk to the child and consider getting professional help. That’s especially true if the child is setting fires to larger objects or in areas where the flames can easily spread and cause injury and damage.

Talk with your doctor or consult a mental health professional if your child exhibits behaviors such as:

  • adding more fuel to fires in the fireplace, grill, or campfires, even when told not to
  • pocketing matches or hiding fire-starting materials
  • lighting candles, fireworks, and other things, despite being told not to

Kids might set fires for any number of reasons. They may be angry or looking for attention. They may be struggling with stressful problems at home, at school, or with friends. Some set fires as a cry for help because they’re being neglected at home or even abused. Even if they know how dangerous fire can be, they might have other problems that involve difficulty with impulse control.

Whatever the reason for firesetting, parents need to get to the root of the behavior and address underlying problems. It’s important to consider seeking professional help as soon as possible to prevent serious damage or injury.

Ron Huxley’s Response: I wanted to find an article on firesetting because it is a problem that we (parents and professionals) don’t talk much about. This blog post gives a good introduction into firesetting by children. It follows my “80/20” rule about misbehavior: 80% of the children do it for curiosity and attention-getting. 20% do it for more serious, underlying causes. It is this later group that parents need to take action on immediately by consulting with a professional. How have you dealt with this frightening behavior?