Saturday, March 20, 2010
Nature, Nurture, and Handedness
by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.
We're used to thinking of human characteristics as either inherited or learned--in other words, the old "nature vs. nurture" controversy. Unfortunately, for many of the characteristics that matter most--such as temperament and personality, and physical, artistic, and intellectual abilities--the best explanation is a complex mixture of both.
In the case of handedness, the nature-nurture controversy isn't just academic. If handedness is learned, then it can be unlearned. That line of thinking would support teaching all children to use their right hands, even though the left might feel more comfortable. But if handedness is inherited, then trying to change a child's preference might be seen as going against nature.
Neither a wholly genetic nor a learning-based explanation fits for handedness. Here are some of the facts, and what they mean.
Handedness runs in families. If both parents are right-handed, 92 to 96 percent of their children will be right-handed, too. If both parents are left-handed, 45 to 50 percent of their children will be left-handed (which also means that roughly half will still be right-handed). When one parent is a lefty and the other a righty, about 80 percent of their children will be right-handed. All of the above fits nicely with a genetic explanation.
Of course, the fact that handedness runs in families could be explained by learning. Since most people in society are right-handed, right-handed parents would have an easy time teaching their children to be right-handed. Left-handed parents would be working against the tide, and so a greater percentage of children would turn out right-handed, despite their parents' efforts. But what the learning explanation can't explain is why any children of right-handed parents would turn out to be left-handed! Also, very young infants show left- or right-sided preferences (see How Handedness Develops in Infants) that are related to their eventual handedness. It's hard to imagine that parents are teaching their children these things.
Among adopted children, the patterns of handedness are related to their biological parents, not their adoptive ones--more strong support for a genetic cause.
On the other hand, the evidence from studies of twins goes against genetics. Identical twins, who develop from a single egg, share the same genes. Fraternal twins, who develop from two different eggs, have about half of their genes in common. If genes were directly responsible for handedness, you'd expect identical twins to always have the same handedness--both being either right-handed or left-handed. You would think that fraternal twins, however, would only have the same likelihood of handedness as any other siblings.
In fact, the number of pairs where one twin is left-handed and the other right is about 20 to 30 percent regardless of whether they're identical or not. To further complicate the matter, there is controversy about a possible connection between left-handedness and twinning (which I won't get into!), but that doesn't change the fact that straightforward genetics can't account for how identical twins can be so different when it comes to handedness.
Making sense of the puzzle
There are lots of theories about how genes and learning or other influences might combine to produce these patterns of handedness. The one that makes the most sense to me is that most people carry a gene that increases the chance that they will be right-handed. Those children who have a full dose of the gene (that is, they inherited it from both parents), are very likely to be right-handed, but still have some small chance of ending up left-handed. Those who don't have the gene at all are about equally likely to develop as left-handed or right-handed. Those who have a half dose of the gene (say, from their mother but not their father) have better than average odds of becoming right-handed, although a small chance still remains that they'll develop into left-handers.
This theory can explain how two left-handed parents can have a right-handed child, and how two right-handed parents can have a left-handed child, and also why twins with identical genes could develop different handedness. We're not used to thinking about things happening just by chance, but that is probably how a lot of development comes about.
What it means for parents
Learning probably plays only a small role in handedness. It may be possible to teach some left-handed children to act as right-handers (or at least to write with their right hands), but the process is bound to be difficult and may not offer any real benefits.
Credit to Chin Yee Jah, T5
Retrieved from http://www.drspock.com/article/0,1510,5817,00.html
Friday, March 19, 2010
Joseph S. Volpe, Ph.D., B.C.E.T.S.
Director, Professional Development
Nationwide Crisis Line and Hotline Directory
I. What Is Domestic Violence?
In the past two decades, there has been growing recognition of the prevalence of domestic violence in our society. Moreover, it has become apparent that some individuals are at greater risk for victimization than others. Domestic violence has adverse effects on individuals, families, and society in general.
Domestic violence includes physical abuse, sexual abuse, psychological abuse, and abuse to property and pets (Ganley, 1989). Exposure to this form of violence has considerable potential to be perceived as life-threatening by those victimized and can leave them with a sense of vulnerability, helplessness, and in extreme cases, horror. Physical abuse refers to any behavior that involves the intentional use of force against the body of another person that risks physical injury, harm, and/or pain (Dutton, 1992). Physical abuse includes pushing, hitting, slapping, choking, using an object to hit, twisting of a body part, forcing the ingestion of an unwanted substance, and use of a weapon. Sexual abuse is defined as any unwanted sexual intimacy forced on one individual by another. It may include oral, anal, or vaginal stimulation or penetration, forced nudity, forced exposure to sexually explicit material or activity, or any other unwanted sexual activity (Dutton, 1994). Compliance may be obtained through actual or threatened physical force or through some other form of coercion. Psychological abuse may include derogatory statements or threats of further abuse (e.g., threats of being killed by another individual). It may also involve isolation, economic threats, and emotional abuse.
II. Prevalence of Domestic Violence
Domestic violence is widespread and occurs among all socioeconomic groups. In a national survey of over 6,000 American families, it was estimated that between 53% and 70% of male batterers (i.e., they assaulted their wives) also frequently abused their children (Straus & Gelles, 1990). Other research suggests that women who have been hit by their husbands were twice as likely as other women to abuse a child (CWP, 1995).
Over 3 million children are at risk of exposure to parental violence each year (Carlson, 1984). Children from homes where domestic violence occurs are physically or sexually abused and/or seriously neglected at a rate 15 times the national average (McKay, 1994). Approximately, 45% to 70% of battered women in shelters have reported the presence of child abuse in their home (Meichenbaum, 1994). About two-thirds of abused children are being parented by battered women (McKay, 1994). Of the abused children, they are three times more likely to have been abused by their fathers.
Studies of the incidence of physical and sexual violence in the lives of children suggest that this form of violence can be viewed as a serious public health problem. State agencies reported approximately 211,000 confirmed cases of child physical abuse and 128,000 cases of child sexual abuse in 1992. At least 1,200 children died as a result of maltreatment. It has been estimated that about 1 in 5 female children and 1 in 10 male children may experience sexual molestation (Regier & Cowdry, 1995).
III. Domestic Violence as a Cause of Traumatic Stress
As the incidence of interpersonal violence grows in our society, so does the need for investigation of the cognitive, emotional and behavioral consequences produced by exposure to domestic violence, especially in children. Traumatic stress is produced by exposure to events that are so extreme or severe and threatening, that they demand extraordinary coping efforts. Such events are often unpredicted and uncontrollable. They overwhelm a person's sense of safety and security.
Terr (1991) has described "Type I" and "Type II" traumatic events. Traumatic exposure may take the form of single, short-term event (e.g., rape, assault, severe beating) and can be referred to as "Type I" trauma. Traumatic events can also involve repeated or prolonged exposure (e.g., chronic victimization such as child sexual abuse, battering); this is referred to as "Type II" trauma. Research suggests that this latter form of exposure tends to have greater impact on the individual's functioning. Domestic violence is typically ongoing and therefore, may fit the criteria for a Type II traumatic event.
With repeated exposure to traumatic events, a proportion of individuals may develop Posttraumatic Stress Disorder (PTSD). PTSD involves specific patterns of avoidance and hyperarousal. Individuals with PTSD may begin to organize their lives around their trauma. Although most people who suffer from PTSD (especially, in severe cases) have considerable interpersonal and academic/occupational problems, the degree to which symptoms of PTSD interfere with overall functioning varies a great deal from person to person.
The Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV; APA, 1994) stipulates that in order for an individual to be diagnosed with posttraumatic stress disorder, he or she must have experienced or witnessed a life-threatening event and reacted with intense fear, helplessness, or horror. The traumatic event is persistently reexperienced (e.g., distressing recollections), there is persistent avoidance of stimuli associated with the trauma, and the victim experiences some form of hyperarousal (e.g., exaggerated startle response). These symptoms persist for more than one month and cause clinically significant impairment in daily functioning. When the disturbance lasts a minimum of two days and as long as four weeks from the traumatic event, Acute Stress Disorder may be a more accurate diagnosis.
It has been suggested that responses to traumatic experience(s) can be divided into at least four categories (for a complete review, see Meichenbaum, 1994). Emotional responses include shock, terror, guilt, horror, irritability, anxiety, hostility, and depression. Cognitive responses are reflected in significant concentration impairment, confusion, self-blame, intrusive thoughts about the traumatic experience(s) (also referred to as flashbacks), lowered self-efficacy, fears of losing control, and fear of reoccurrence of the trauma. Biologically-based responses involve sleep disturbance (i.e., insomnia), nightmares, an exaggerated startle response, and psychosomatic symptoms. Behavioral responses include avoidance, social withdrawal, interpersonal stress (decreased intimacy and lowered trust in others), and substance abuse. The process through which the individual has coped prior to the trauma is arrested; consequently, a sense of helplessness is often maintained (Foy, 1992).
IV. Possible Signs and Symptoms of Domestic Violence in Children and Adolescents
More than half of the school-age children in domestic violence shelters show clinical levels of anxiety or posttraumatic stress disorder (Graham-Bermann, 1994). Without treatment, these children are at significant risk for delinquency, substance abuse, school drop-out, and difficulties in their own relationships.
Children may exhibit a wide range of reactions to exposure to violence in their home. Younger children (e.g., preschool and kindergarten) oftentimes, do not understand the meaning of the abuse they observe and tend to believe that they "must have done something wrong." Self-blame can precipitate feelings of guilt, worry, and anxiety. It is important to consider that children, especially younger children, typically do not have the ability to adequately express their feelings verbally. Consequently, the manifestation of these emotions are often behavioral. Children may become withdrawn, non-verbal, and exhibit regressed behaviors such as clinging and whining. Eating and sleeping difficulty, concentration problems, generalized anxiety, and physical complaints (e.g., headaches) are all common.
Unlike younger children, the pre-adolescent child typically has greater ability to externalize negative emotions (i.e., to verbalize). In addition to symptoms commonly seen with childhood anxiety (e.g., sleep problems, eating disturbance, nightmares), victims within this age group may show a loss of interest in social activities, low self-concept, withdrawal or avoidance of peer relations, rebelliousness and oppositional-defiant behavior in the school setting. It is also common to observe temper tantrums, irritability, frequent fighting at school or between siblings, lashing out at objects, treating pets cruelly or abusively, threatening of peers or siblings with violence (e.g., "give me a pen or I will smack you"), and attempts to gain attention through hitting, kicking, or choking peers and/or family members. Incidentally, girls are more likely to exhibit withdrawal and unfortunately, run the risk of being "missed" as a child in need of support.
Adolescents are at risk of academic failure, school drop-out, delinquency, and substance abuse. Some investigators have suggested that a history of family violence or abuse is the most significant difference between delinquent and non delinquent youth. An estimated 1/5 to 1/3 of all teenagers who are involved in dating relationships are regularly abusing or being abused by their partners verbally, mentally, emotionally, sexually, and/or physically (SASS, 1996). Between 30% and 50% of dating relationships can exhibit the same cycle of escalating violence as marital relationships (SASS, 1996).
V. Helping Children and Adolescents Exposed to Domestic Violence
For some children and adolescents, questions about home life may be difficult to answer, especially if the individual has been "warned" or threatened by a family member to refrain from "talking to strangers" about events that have taken place in the family. Referrals to the appropriate school personnel could be the first step in assisting the child or teen in need of support. When there is suggestion of domestic violence with a student, consider involving the school psychologist, social worker, guidance counselor and/or a school administrator (when indicated). Although the circumstances surrounding each case may vary, suspicion of child abuse is required to be reported to the local child protection agency by teachers and other school personnel. In some cases, a contact with the local police department may also be necessary. When in doubt, consult with school team members.
If the child expresses a desire to talk, provide them with an opportunity to express their thoughts and feelings. In addition to talking, they may be also encouraged to write in a journal, draw, or paint; these are all viable means for facilitating expression in younger children. Adolescents are typically more abstract in their thinking and generally have better developed verbal abilities than younger children. It could be helpful for adults who work with teenagers to encourage them to talk about their concerns without insisting on this expression. Listening in a warm, non-judgmental, and genuine manner is often comforting for victims and may be an important first step in their seeking further support. When appropriate, individual and/or group counseling should be considered at school if the individual is amenable. Referrals for counseling (e.g., family counseling) outside of the school should be made to the family as well. Providing a list of names and phone numbers to contact in case of a serious crisis can be helpful.
Psychological Impact Of Child Abuse
ScienceDaily (May 24, 2009) — According to a new Mayo Clinic study, a history of child abuse significantly impacts the wide range of challenges facing depressed inpatients. Included are an increase in suicide attempts, prevalence of substance use disorder, and a higher incidence rate of personality disorder.
Additionally, these victims also had an earlier onset of mental illness and an increase in psychiatric hospitalizations for psychiatric issues. The study was presented at the American Psychiatric Association 2009 Annual Meeting in San Francisco.
The impact of child abuse already is known to increase the risk of suicide, however the literature about other characteristics of depressed victims of child abuse is scarce. Although the findings of the Mayo study do not confirm causality, the information stresses the importance of more aggressive approaches from the public health perspective to prevent child abuse. "A history of child abuse makes most psychiatric illnesses worse," according to Magdalena Romanowicz, M.D., lead author of the study. "We found that it significantly impacts the wide range of characteristics of depressed inpatients including increased risk of suicide attempt, substance abuse, as well as earlier onset of mental illness and more psychiatric hospitalizations. This new information serves as a reminder of the importance of child abuse prevention from a public health perspective."
Thursday, March 18, 2010
Wednesday, March 17, 2010
Tuesday, March 16, 2010
Our personality traits come in opposites. We think of ourselves as optimistic or pessimistic, independent or dependent, emotional or unemotional, adventurous or cautious, leader or follower, aggressive or passive. Many of these are inborn temperament traits, but other characteristics, such as feeling either competent or inferior, appear to be learned, based on the challenges and support we receive in growing up.
The man who did a great deal to explore this concept is Erik Erikson. Although he was influenced by Freud, he believed that the ego exists from birth and that behavior is not totally defensive. Based in part on his study of Sioux Indians on a reservation, Erikson became aware of the massive influence of culture on behavior and placed more emphasis on the external world, such as depression and wars. He felt the course of development is determined by the interaction of the body (genetic biological programming), mind (psychological), and cultural (ethos) influences.
He organized life into eight stages that extend from birth to death (many developmental theories only cover childhood). Since adulthood covers a span of many years, Erikson divided the stages of adulthood into the experiences of young adults, middle aged adults and older adults. While the actual ages may vary considerably from one stage to another, the ages seem to be appropriate for the majority of people.
Erikson's basic philosophy might be said to rest on two major themes: (1) the world gets bigger as we go along and (2) failure is cumulative. While the first point is fairly obvious, we might take exception to the last. True, in many cases an individual who has to deal with horrendous circumstances as a child may be unable to negotiate later stages as easily as someone who didn't have as many challenges early on. For example, we know that orphans who weren't held or stroked as infants have an extremely hard time connecting with others when they become adults and have even died from lack of human contact.
However, there's always the chance that somewhere along the way the strength of the human spirit can be ignited and deficits overcome. Therefore, to give you an idea of another developmental concept, be sure to see Stages of Growth for Children and Adults, based on Pamela Levine's work. She saw development as a spiraling cycle rather than as stages through which we pass, never to visit again.
As you read through the following eight stages with their sets of opposites, notice which strengths you identify with most and those you need to work on some more.
1. Infancy: Birth to 18 Months
Ego Development Outcome: Trust vs. Mistrust
Basic strength: Drive and Hope
Erikson also referred to infancy as the Oral Sensory Stage (as anyone might who watches a baby put everything in her mouth) where the major emphasis is on the mother's positive and loving care for the child, with a big emphasis on visual contact and touch. If we pass successfully through this period of life, we will learn to trust that life is basically okay and have basic confidence in the future. If we fail to experience trust and are constantly frustrated because our needs are not met, we may end up with a deep-seated feeling of worthlessness and a mistrust of the world in general.
Incidentally, many studies of suicides and suicide attempts point to the importance of the early years in developing the basic belief that the world is trustworthy and that every individual has a right to be here.
Not surprisingly, the most significant relationship is with the maternal parent, or whoever is our most significant and constant caregiver.
2. Early Childhood: 18 Months to 3 Years
Ego Development Outcome: Autonomy vs. Shame
Basic Strengths: Self-control, Courage, and Will
During this stage we learn to master skills for ourselves. Not only do we learn to walk, talk and feed ourselves, we are learning finer motor development as well as the much appreciated toilet training. Here we have the opportunity to build self-esteem and autonomy as we gain more control over our bodies and acquire new skills, learning right from wrong. And one of our skills during the "Terrible Two's" is our ability to use the powerful word "NO!" It may be pain for parents, but it develops important skills of the will.
It is also during this stage, however, that we can be very vulnerable. If we're shamed in the process of toilet training or in learning other important skills, we may feel great shame and doubt of our capabilities and suffer low self-esteem as a result.
The most significant relationships are with parents.
3. Play Age: 3 to 5 Years
Ego Development Outcome: Initiative vs. Guilt
Basic Strength: Purpose
During this period we experience a desire to copy the adults around us and take initiative in creating play situations. We make up stories with Barbie's and Ken's, toy phones and miniature cars, playing out roles in a trial universe, experimenting with the blueprint for what we believe it means to be an adult. We also begin to use that wonderful word for exploring the world—"WHY?"
While Erikson was influenced by Freud, he downplays biological sexuality in favor of the psychosocial features of conflict between child and parents. Nevertheless, he said that at this stage we usually become involved in the classic "Oedipal struggle" and resolve this struggle through "social role identification." If we're frustrated over natural desires and goals, we may easily experience guilt.
The most significant relationship is with the basic family.
4. School Age: 6 to 12 Years
Ego Development Outcome: Industry vs. Inferiority
Basic Strengths: Method and Competence
During this stage, often called the Latency, we are capable of learning, creating and accomplishing numerous new skills and knowledge, thus developing a sense of industry. This is also a very social stage of development and if we experience unresolved feelings of inadequacy and inferiority among our peers, we can have serious problems in terms of competence and self-esteem.
As the world expands a bit, our most significant relationship is with the school and neighborhood. Parents are no longer the complete authorities they once were, although they are still important.
5. Adolescence: 12 to 18 Years
Ego Development Outcome: Identity vs. Role Confusion
Basic Strengths: Devotion and Fidelity
Up to this stage, according to Erikson, development mostly depends upon what is done to us. From here on out, development depends primarily upon what we do. And while adolescence is a stage at which we are neither a child nor an adult, life is definitely getting more complex as we attempt to find our own identity, struggle with social interactions, and grapple with moral issues.
Our task is to discover who we are as individuals separate from our family of origin and as members of a wider society. Unfortunately for those around us, in this process many of us go into a period of withdrawing from responsibilities, which Erikson called a "moratorium." And if we are unsuccessful in navigating this stage, we will experience role confusion and upheaval.
A significant task for us is to establish a philosophy of life and in this process we tend to think in terms of ideals, which are conflict free, rather than reality, which is not. The problem is that we don't have much experience and find it easy to substitute ideals for experience. However, we can also develop strong devotion to friends and causes.
It is no surprise that our most significant relationships are with peer groups.
6. Young adulthood: 18 to 35
Ego Development Outcome: Intimacy and Solidarity vs. Isolation
Basic Strengths: Affiliation and Love
In the initial stage of being an adult we seek one or more companions and love. As we try to find mutually satisfying relationships, primarily through marriage and friends, we generally also begin to start a family, though this age has been pushed back for many couples who today don't start their families until their late thirties. If negotiating this stage is successful, we can experience intimacy on a deep level.
If we're not successful, isolation and distance from others may occur. And when we don't find it easy to create satisfying relationships, our world can begin to shrink as, in defense, we can feel superior to others.
Our significant relationships are with marital partners and friends.
7. Middle Adulthood: 35 to 55 or 65
Ego Development Outcome: Generativity vs. Self absorption or Stagnation
Basic Strengths: Production and Care
Now work is most crucial. Erikson observed that middle-age is when we tend to be occupied with creative and meaningful work and with issues surrounding our family. Also, middle adulthood is when we can expect to "be in charge," the role we've longer envied.
The significant task is to perpetuate culture and transmit values of the culture through the family (taming the kids) and working to establish a stable environment. Strength comes through care of others and production of something that contributes to the betterment of society, which Erikson calls generativity, so when we're in this stage we often fear inactivity and meaninglessness.
As our children leave home, or our relationships or goals change, we may be faced with major life changes—the mid-life crisis—and struggle with finding new meanings and purposes. If we don't get through this stage successfully, we can become self-absorbed and stagnate.
Significant relationships are within the workplace, the community and the family.
8. Late Adulthood: 55 or 65 to Death
Ego Development Outcome: Integrity vs. Despair
Basic Strengths: Wisdom
Erikson felt that much of life is preparing for the middle adulthood stage and the last stage is recovering from it. Perhaps that is because as older adults we can often look back on our lives with happiness and are content, feeling fulfilled with a deep sense that life has meaning and we've made a contribution to life, a feeling Erikson calls integrity. Our strengt h comes from a wisdom that the world is very large and we now have a detached concern for the whole of life, accepting death as the completion of life.
On the other hand, some adults may reach this stage and despair at their experiences and perceived failures. They may fear death as they struggle to find a purpose to their lives, wondering "Was the trip worth it?" Alternatively, they may feel they have all the answers (not unlike going back to adolescence) and end with a strong dogmatism that only their view has been correct.
Month 1: Your first month of pregnancy your baby will accomplish many things, first and foremost, conception, fertilization, and implantation. After a woman ovulates, the egg is normally fertilized within 24-48 hours. The single fertilized cell begins to rapidly divide and at this point in time is called a zygote. Many amazing things happen at fertilization. Your baby's entire physical attributes are determined including gender, hair color, and eye color. Between days 7-10 from fertilization implantation usually occurs. Implantation should occur within the uterus if it does not this is considered an ectopic pregnancy. The amniotic sac, umbilical cord and yolk sac are already beginning to form. By the end of this month your baby is approximately 2mm long and beginning early stages of development.
Monday, March 15, 2010
Yes. Childhood depression is different from the normal "blues" and everyday emotions that occur as a child develops. Just because a child seems depressed or sad, does not necessarily mean they have depression. But if these symptoms become persistent, disruptive, and interfere with social activities, interests, schoolwork and family life, it may indicate that he or she has the medical illness called depression. Keep in mind that while depression is a serious illness, it is also a treatable one.
How Can I Tell if My Child is Depressed?
The symptoms of depression in children vary. It is often undiagnosed and untreated because they are passed off as normal emotional and psychological changes that occur during growth. Early medical studies focused on "masked" depression, where a child's depressed mood was evidenced by acting out or angry behavior. While this does occur, particularly in younger children, many children display sadness or low mood similar to adults who are depressed. The primary symptoms of depression revolve around sadness, a feeling of hopelessness, and mood changes.
Signs and symptoms of depression in children include:
* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite -- either increased or decreased
* Changes in sleep -- sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to treatment
* Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide
Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol, especially if they are over the age of 12.
Although relatively rare in youths under 12, young children do attempt suicide -- and may do so impulsively when they are upset or angry. Girls are more likely to attempt suicide, but boys are more likely to actually kill themselves when they make an attempt. Children with a family history of violence, alcohol abuse, or physical or sexual abuse are at greater risk for suicide, as are those with depressive symptoms.
Which Children Get Depressed?
It is estimated that 2.5% of children in the U.S. suffer from depression. Depression is significantly more common in boys under the age of 10. But by age 16, girls have a greater incidence of depression.
Bipolar disorder is more common in adolescents than in younger children. Bipolar disorder in children can, however, be more severe than in adolescents. It may also co-occur with, or be hidden by, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or conduct disorder (CD). According to the National Institute of Mental Health, 20-40% of adolescents with major depression develop bipolar disorder within five years after having depression.
What Causes Depression in Children?
As in adults, depression in children can be caused by any combination of factors that relate to physical health, life events, family history, environment, genetic vulnerability, and biochemical disturbance. Depression is not a passing mood, nor is it a condition that will go away without proper treatment.
Can Depression in Children Be Prevented?
Children with a family history of depression are at greater risk of experiencing depression themselves. Children who have parents that suffer from depression tend to develop their first episode of depression earlier than children whose parents do not. Children from chaotic or conflicted families, or children and teens who abuse substances like alcohol and drugs, are also at greater risk of depression.
How is the Diagnosis Made?
If the symptoms of depression in your child have lasted for at least two weeks, you should schedule a visit with his or her doctor to make sure there are no physical reasons for the symptoms and to make sure that your child receives proper treatment. A consultation with a mental healthcare professional who specializes in children is also recommended.
A mental health evaluation should include interviews with you (as the parents) and your child, and any additional psychological testing that is necessary. Information from teachers, friends, and classmates can be useful for showing that these symptoms are consistent during your child's various activities and are a marked change from previous behavior.
There are no specific tests -- medical or psychological -- that can clearly show depression, but tools such as questionnaires (for both the child and parents) combined with personal information can be very useful.
What Are the Treatment Options?
Treatment options for children with depression are similar to those for adults, including psychotherapy (counseling) and medicine . The role that family and the child's environment play in the treatment process is different from that of adults. Your child's doctor may suggest psychotherapy first, and consider antidepressant medicine as an additional option if there is no significant improvement. Currently, there are no good studies documenting the effectiveness of medicine over psychotherapy in children.
However, three studies do show that the antidepressant Prozac is effective in treating depression in children and teens. The drug is officially recognized by the FDA for treatment of children 8-18 with depression.
Treating children with bipolar disorder
Children with bipolar disorder are usually treated with psychotherapy and a combination of medicines, usually an antidepressant and a mood stabilizer. Use of an antidepressant alone can trigger bouts of mania.
The FDA has determined that antidepressant medications increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider.
What Can I Expect Long-Term?
Studies have found that first-time depression in children is occurring at younger ages than previously. As in adults, it may occur again later in life. Depression often occurs at the same time as other physical illnesses. And because studies have shown that depression may precede more serious mental illness later in life, diagnosis, early treatment, and close monitoring are crucial.
A Parent's Perspective
As a parent, it is sometimes easier to deny that your child has depression. You may put off seeking the help of a mental healthcare professional because of the social stigmas associated with mental illness. It is very important for you -- as the parent -- to understand depression and realize the importance of treatment so that your child may continue to grow physically and emotionally in a healthy way. It is also important to seek education about the future effects depression may have on your child throughout adolescence and adulthood.
Parents should be particularly vigilant for signs that may indicate that their child is at risk for suicide.
Warning signs of suicidal behavior in children include:
* Many depressive symptoms (changes in eating, sleeping, activities)
* Social isolation
* Talk of suicide, hopelessness, or helplessness
* Increased acting-out behaviors (sexual/behavioral)
* Increased risk-taking behaviors
* Frequent accidents
* Substance abuse
* Focus on morbid and negative themes
* Talk about death and dying
* Increased crying and reduced emotional expression
* Giving away possessions
By Koh Mei Poh, T2
A child's brain develops exponentially during the earliest years of their young life. All interactions between babies and their parents encourage the development and growth of tiny fibers called synapses. Even the earliest experiences can have the most significant effect on the young developing brain.
The journey to learning begins with the initial step when a parent teaches their infant to adapt to their new surroundings, by teaching them to eat, learn and respond to stimuli. Babies learn to give cues to their needs and abilities. Before they can run they learn to walk, before they walk they learn to crawl, before the crawl they learn to push themselves up. Each step is arduous and babies, often times, practice each step of the process over and over until they perfect it. Parents should familiarize themselves with their child's cues. Every child exhibits readiness to move on to the next step. It is the parents' job to recognize when the child should be guided to the next step or know when the teaching process should be set aside before frustration sets in on both parties.
Parents are their child's first teachers. From them children learn to thrive or fail by giving up. Studies have shown that children with active parents that take a concerted role in their child's learning adapt better to their surroundings. Research done in many European countries that house large orphanages where there is lack of interaction between children and adults show those children develop slower and learn with greater difficulty.
Learning in the Real World
There is a saying that life can be the greatest teacher. Infants instinctively know that they must learn to breathe and take in nutrients to survive. They begin to recognize the correlation between crying and getting their need met. Parents learnt that each cry is a different indicator to their child's needs.
Toddlers increase their knowledge through trial and error. Experience will remind them if a certain task or situation is enjoyable or not. It is then that they learn when to continue a certain set of experiences to attain a desired objective. For instance, an infant yearns to be mobile. They quickly realize that if they exert a little energy they can move toward a desired result. They practice even in their sleep until they achieve their goal of movement. They may experience a few falls along the way but they learn to work through the difficulty to reach the end. This process teaches them that failure is an acceptable stepping stone to success. Experience can also forewarn them of danger or unpleasantness.
Children also learn to interact with others through interactive play. They learn to take turns, follow rules and they learn sociably acceptable behaviors. They learn social skills that they will use throughout their life.
Part I: Surround Your Child with Learning
Every aspect of life can be a learning opportunity. Be descriptive to your young child when you're interacting with them. Continually use the same method to reinforce what you are trying to teach them. A child learns through repetition. The more they are exposed to the lesson that the parent wants them to learn the better their chances are in retaining the information.
Instead of just handing the child their favorite toy or comfort item describe it to them. For example, a parent can say 'here's your blanket' or the parent can seize the opportunity to reinforce a color lesson by stating 'here's your red/yellow/blue or green blanket'. You cannot start too early in the learning process.
When changing a diaper, that moment can be turned into a lesson for the child about body awareness. Describe the type of diaper the child had. This makes him/her aware of his/her body functions and is very useful when potty training. The parent can also use the short down time, when the child's attention is captured to learn body parts. Repeating the exercise often helps reinforce what they have been taught, soon they can repeat the labeled part then progressing to answering the question when they are asked for the part or objects name.
Even playing at the park can be a great tool for learning. Children can enhance their problem solving skills by trying various ways of getting from point A to point B. They learn and enhance social skills, in regard, to strangers. Count with them the steps that they climb and the action becomes a math lesson. State the color of the slide they use. Help them learn the difference between various surfaces and words by correlating it to the object that they are using. This attaches more meaning to what they are being taught. If they can actually see what it is they are hearing they can retain the information better.
Consistent labeling creates familiarity with what is being taught. They soon begin to repeat by mimicking the parents' words or actions. Eventually they begin to attach meaning to the word or action. They move to doing what they have learned on their own because they have gained understanding. Their vocabulary is built upon each word that they learn the meaning to thus building and increasing their conversational skills.
Watching television is not the desired approach to teaching children but there are some educational shows that will reinforce what they are learning from the parent or school. It is up to the parent to decide how they can effectively use the television as a tool.
Learning also happens through play. The activity inspires the imagination. A lot of how they interact in this type of play is what they observe from their surroundings or environment. They mimic interactions between families and friends as well as the process of a given task.
Play in a young child's life can teach them the fundamentals necessary to learn as they get older. Play can improve both fine and large motor skills, vocabulary and language skills as well as social skills. Do not rule out play as an important stepping stone in the learning process.
Part II: Reading Success
There are several schools of thought in regards to the best way to teach a child to read. Many attest that phonics is the sole way, in which a child should read. Others rely on the sight word method as their primary source of teaching. However, a combination of both methods may be the most accurate and well-rounded approach to learning to read.
Learning to read can be an arduous and time-consuming process. Parents must first develop an insight on how children learn before they can effectively teach them with minimal frustration to parent and child. Children can easily be overloaded with information when too much is introduced at any one time. Parents must pace themselves and their children to capitalize on success.
Start with small goals before moving on to more complex ones. Once the goals are met praise the child and reinforce what they learn through repetition. Take one objective and teach it to your child and spread the same lesson out over a week's time before moving on to the next lesson. Intermittently, review the learned objectives, this continually reinforces what they learned.
Begin by familiarizing your child with the alphabet. Songs with letters are fun and stimulate children into being active participants in the learning process. Take a letter per week when beginning a more in-depth approach to learning to recognize letters and their corresponding sound. Emphasize words within the child's environment that begin with that particular letter.
Adapt games that involve your children, to help reinforce the letters that you are teaching. For instance, playing tic-tac-toe with the letters d and b. Each space is awarded when a word beginning with each letter is stated.
When reading include your child in the process. Begin with books that capture your child's attention and imagination. As the child looks at the books begin by pointing to the word that is being read. Have the child echo what is being read. This gives him or her practice on the process of reading. They may not know at first what they are reading but they soon learn to correlate specific letter groupings with particular words. You may also wish to engage in simultaneous reading. This exercise also involves the child in the process; this is especially useful when there are repeating patterns in the text.
Flash cards with pictures help children identify and recognize letter groupings. They learn to relate the pictures with the words, giving them a mental image that stays with them. Make sure that each letter or cluster of letters is sounded out to emphasize letter-sound recognition.
Reading is fundamental to learning and developing other skills. All aspects of the child's education are based on their ability to read and decipher what is in front of them.
Part III: The Road to Developing Math Skills
Recognizing numbers is as important in your child's learning as recognizing letters. Math is introduced in the same way that they learn to read. A child must first learn the corresponding symbol that represents a certain number.
Parents can introduce the numbers 1-5, and then as they begin to master them others can be introduced. By preschool they should be able to recognize numbers up to 20, many can master up to 100 without much difficulty. Children can easily be taught number patterns. A good way to introduce this exercise would be to write down a numbers 1 through 100, make it fun, let each number represent a section on a long caterpillar. Point to each number that is in the number pattern, such as counting by ones, fives, tens etceteras.
Encourage your young child's curiosity by setting out a number of certain category of items then ask the child to pick out a certain number of them. Continually count with them reinforcing with repetition.
Begin adding and subtracting basic numbers by representing them with objects. The objects help the child relate the number sequence and make it easier for them to relate to what is being taught. Try to use the same objects so the child is not confused. For example, use blocks. Have them count the number of blocks then begin to add and subtract blocks, each time having them recount the remaining. Make the process into a game and they will feel more inspired and less pressured.
A great way to teach your child coin recognition is by placing a large number of various coins in a bag they cannot see through. Have them place their hand inside the bag and retrieve a coin then have them state what type of coin they have pulled out. Set a timer so they can better their score each time, giving them a discernable goal to reach toward. If more than one child is involved change the rules so that the first person to a certain number wins the game. This not only teaches them coin recognition and counting, but it encourages controlled competition, which helps them to learn to be good losers as well as good winners.
Use inventive ways to introduce math without the dread that many associate with learning math. Word pictures help to solidify what they are being taught. Games help them to relate math with fun.
Part IV: Bringing it together
Be innovative as a parent when teaching your child. The more you involve them and make them an active participant the more pleasure they take in learning. Over-saturation can lead to frustration and an unwillingness to try to learn. If the process of learning is presented in a fun and exciting way the child is more willing to attempt learning and is better able to retain the information.
Repetition is far different from drilling the lesson. Repetition can take many various forms. One moment it can be a game and the next it can take the form of a song. It is up to the parent to find what best motivates his or her own child. Leave the criticizing outside the learning process, it frustrates the child and is not conducive to learning. A child can easily be discouraged if they are made to feel that they are not successfully doing the lesson right, but by creating an environment of fun, encouragement and praise a child can learn at his or her own pace. Teach the process and then let them try on their own. By doing this, the parent encourages independence and builds confidence.
Involve your children with others. Join a playgroup or developmental class. These interactions teach social skills necessary to function in the world. They learn to deal with difficult situations and people and they encourage problem-solving skills.
Make the most of every opportunity when it is presented. Through repetition and familiarization a child can retain the information that is being presented. There will be times when your child will learn something taught, then seemingly not know it. With continued exposure those lapses become fewer and they will eventually retain the information presented to them.
By Koh Mei Poh (Carmen), T2