Tag Archives: Parent

I would go nuts!

Imagine having a child with such severe allergies that they can die from intake of the smallest amount of the allergen. We have friends who have a daughter who has 22 allergies and has been hospitalised 30 (!) times for anaphylactic shock. That’s 30 times of not knowing whether your child will make it or not.

The mother of this child desperately pleads to all staff caring for children to understand that this really is serious. The last hospitalisation had been caused by a mistake in the school kitchen: the staff mixed up lactose intolerance and cow milk protein allergy, so the child’s special food had been prepared with lactose free milk – full of the cow milk protein she was so allergic to!

Such mistakes are awful and unprofessional, but avoidable with further education and better routines. But what about something as simple as picking up some groceries? As a parent to an allergic child, shopping will take you much longer as you read every single label to make sure your child is not exposed to anything dangerous. You become painfully aware that most of the things you used to shop say “may contain traces of nuts”; in fact, 65% of all products in a supermarket have precautionary labelling!

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At every birthday party or dinner invitation, the hosts will empathise with you as they discover during their preparations that anything and everything may contain traces of either peanuts, tree nuts, egg, milk, sesame, fish, wheat, or soy.

Which is why a study performed by the Murdoch Children’s Research Institute is both so elegant, important, and frustrating. The allergy team at MCRI clearly understood the everyday stresses of parents when they designed this study. They selected 128 items among chocolates, breakfast cereals, muesli bars, biscuits, and cookies, foods most likely to carry precautionary labelling. If you are a parent or grandparent, start counting how many such items you purchased last time you went shopping for the kids.

Of the 128 samples, only nine (7%) with precautionary labelling had detectable levels of peanut. The others had nothing! Of products that had precautionary labelling for hazelnut, milk, egg, or soy, none were found to have any detectable level of those allergens. None! Of the 9 samples containing peanut, all were below the dose someone allergic to peanuts would react to.

Good thing then, that 22% of parents of children with food allergies simply ignored precautionary labelling statements, according to a survey performed by the same research group. But would you dare to ignore such statements if your child had been hospitalised 30 times for anaphylactic shock?!

So why do manufacturers employ precautionary labelling? Of  course because they want to avoid liability. And because there is legislation to say product content has to be stated. The big question is why they are still allowed precautionary labelling in most countries? Why is it ok for billion dollar industries to routinely print such statements on their products, putting the workload of selecting possible products for their children to eat on parents who are already under enough stress?

As a parent of a severely allergic child I would go nuts. I can totally see why our friend says she needs to fight for her daughter because no one else will. Except the father, I would hope. And it is a fight with high stakes.

The food industry will not be the one to take the first steps toward more rigorous regulation on the exact amounts of allergen that needs to be present for precautionary labelling. However, judging by the number and intensity of the comments on my friend’s blog post about her daughter’s last hospitalisation, there could be a storm of parents demanding change. And I am proud that my host institution has given them such a firm foundation to stand on with their study.

Have fun at the supermarket next time, figuring out those precautionary labels!

Walking the talk

Being a parenting researcher means I know quite a lot about the theory of good parenting. I have had reason to read the content of a number of parenting programs and picked up ideas I especially like. Friends sometimes ask me for advice with their kids and I often discuss parenting issues with educators, social workers, and mental health professionals. I also enjoyed my placement in child psychiatry because so much could be achieved with some sound parenting advice. However, all too often, I forget to walk the talk myself.

The latest example was our trip to Sydney. We planned it to be a two day drive and the first leg took us from Melbourne to Camberra. We had planned some stops on the way and had a fair idea of the time each leg would take. We had water bottles, charged iPads, and fruit with us. The children played and sang and looked at the view and the trip went really well. We made two fun stops, the second one including a nice surprise with the host on the family estate guiding us around to see something as unlikely as beautifully renovated royal horse carriages from the 1800s in a shed!

Then we forgot all about planning. We spent a night and half a day in the capital city, which just happened to host the open day event for several of the embassies, and then set off to Sydney. No water bottles, or fruit, no planned stops, not even planning for meals and other necessities. I was really beating myself up because it was so stupid, so easy to prevent and still, there we were, killing the enjoyment of the trip with kids fighting in the back and parents ready to give up. By the time we arrived it was dark and dinner still had to be cooked. The only good thing was we weren’t dependent on me to orient in the dark…

There is something in the Positive Parenting Program called the Planned activities routine. It is NOT rocket science. But it works, especially in high-risk situations, such as long trips in the car. Such planning also works well with children who have a hard time adapting to changes and new situations or dislike transitions from one activity to another. Planning ahead and making these plans clear for the children, or indeed involving them in the planning, is something that minimises the risk for the whining and fighting that can occur when everyone is tired, hungry, stressed, overloaded, or all at the same time.

Luckily, when things were at their worst, we stopped at Wollongong, a town right by the sea, and had a long chill on the beach. Because although planning is very effective in decreasing stress and making life easier, what really counts is to be able to deal with difficulties constructively. When sitting in the car and keeping going was just not a viable option, we took a break. The younger ones sat in the sand and built a fortress with water around and our teenager photographed the waves coming in. No one said much, we all needed some peace and quiet, fresh air to breathe, the waves to listen to. But it was one of the nicest hours of our trip, a sunset by the sea, given to us unplanned, unforeseen, but deeply appreciated.

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I guess there is no need to say that when we set out for a day in Sydney, the backpack was properly packed and distances, along with ferry timetables, duly checked. I even had nuts in the car so that the starving troops would have something to munch on until we got home in the evening. But we did take care not to pack the day too tight so there would be time for surprises. For you can only plan so much and you don’t want to have kids believe that everything can be planned and that all uncomfortable things can be avoided.

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Nonetheless, take my advice and use some smart planning before your next long car trip. State your expectations, keep the kids busy and engaged, encourage the behaviours you would like to see and implement consequences for the ones you want to avoid. And be realistic! I will certainly remember to try and walk the talk myself next time around.

You can do it!

The night before my first solo driving trip in Melbourne I had nightmares. It’s not that I don’t like driving – in fact I am an experienced driver and have driven lots of different cars on all sides of the road, big and small, manual and automatic. I drive carefully and confidently and I think I am considerate on the roads. But I am spatially challenged, meaning that I have no sense of direction whatsoever and have therefore serious issues with finding my way. In addition, I cannot tell right from left without thinking hard about it. This challenge of my spatial intelligence is reflected in those parts of the IQ test where you are supposed to match up 3D images with one another to see which of four possible pieces fits with the sample image missing a part. Impossible! How can people figure that out?

Because I am adamant not to let such things restrict me I have had many detours and sweaty arrivals just because I did not take extra precautions or double check my choices on which way to turn while en route. But now that I am soon turning 40 I figure that I have to find a way to live with my spatial challenge and maybe give myself a brake. So I spent some of the evening consulting Google maps while my husband had a fun time proposing seven different routes because it didn’t matter. Well, it did for me, and I chose the most straightforward route that was a bit longer, but much simpler than the others. I memorised the street names and distances, although I also planned to have my laptop on the passenger seat.

Nonetheless, when the morning came I had a lot of excuses ready for why I shouldn’t go or why my husband should come with me. My hesitation could have to do with the fact that, while I was at it, I planned four meetings that day so I not only had to get to one destination, but three, and there was no time for messing up. The reason I didn’t seriously consider just dropping the whole project of driving a fat jeep in left traffic to parts of a huge city I had never been to before was my self-efficacy. I believed I could do it.

In fact, I knew I could do it, that I would figure it out. The term self-efficacy was coined by the psychologist Albert Bandura in his book on Social Learning Theory from 1977. Self-efficacy is a very widely used and cited concept and is related to the person’s belief about his or her ability to complete or master a certain task or meet a challenge effectively. It is for good reason that sports psychology uses self-efficacy as one of its core concepts: you can only visualize yourself with a gold medal in hand if you have high self-efficacy. I did my PhD on Type 2 Diabetes and one of our very interesting findings was the importance of self-efficacy for metabolic control in diabetes. I dare to say the same goes for every single chronic condition and in fact health behaviour in general. We also see the major role self-efficacy plays in parenting.

As simple as it seems, it is true: if you believe you can do something, the odds are that you will succeed. Well, unless you mix up boasting or an unrealistic self-image with self-efficacy. Having high self-efficacy means that you take responsibility for your actions and that the possibility of both success and failure lies within your reach. The good news is that self-efficacy is possible to affect, which indeed is what a lot of cognitive behavioural therapy does. If you don’t believe you can make a change in your life you need to start working on why you don’t believe you can make a change.

I did find my way to all my destinations, drove a total of 72 kilometers, and was not even late. It did help to plan and to ask my researcher colleague for directions at my first destination. It turned out that she knew exactly what it was like to be spatially challenged. So when the road I was driving on did this impossible thing dividing itself into two going in complete different directions I knew what to do because she had told me: stick to the right, let’s see, it’s this hand! I am not alone, in fact there are plenty of us spatially challenged, otherwise rather intelligent, people out there. You can do a simple test to tell: if you call on us to turn right too quickly and without pointing, we will either turn left or say which right?

It did feel a bit phony, but when things got tough that day I just said to myself: you can do it! The best news with self-efficacy is in fact that successes create a positive loop with better self-efficacy and more successes. Parents intuitively know this. So keep chanting “you can do it” to your child the next time it runs into a challenge and a small miracle is bound to happen in front of your eyes. 

Knowing when to let go

“He climbed up there, he’ll get down”, the mother shouted from the bottom of the stairs in the Children’s Hospital. She turned back to her friend and the member of the hospital staff in the stairs and I looked at each other. I offered the child my finger to help him down, but he gave me a terrified look so I just lingered around to catch him in case he fell. The stairs were way too high for a child his age, made of white stone, hard and edgy. The little boy had huge curls surrounding his face and dark brown eyes, conveying no trust in this world. When he had landed safely I continued up the stairs. The staff member rolled her eyes: “Interesting parenting you see around here sometimes”. The scene made me depressed for the rest of the morning.

Teaching a child to learn the consequences of its actions is a core task in parenting. It is a fine line parents need to walk – when to support individuation and let the child experience the consequences of their choices and when to shield them from their own immaturity. It takes sensitivity, afterthought, and a lot of trial and error to know when to let go, when the child is ready to understand the concept of consequences.

Logical consequences is a specific strategy in the Positive Parenting Program, Triple P, but several parenting programs have similar tools. Its purpose is to help children experience consequences of their behaviour in a predictable way. So if two children fight over a toy or device despite the parents asking them to start sharing instead or the toy will go away, the object indeed goes away for five minutes. Logical consequences make sense to the child and are closely related in time to the inadequate behaviour, helping the child make the link. A logical consequence can also be shorter time for play because of time spent whining instead of getting ready or not being able to go shopping with a friend because of missed homework that has to be done.

A logical consequence for the little boy in the stairs for not listening should have been to sit in the pram. In fact, given that he was only about 18 months the best choice would probably have been to distract him with something else or why not walk with him a couple of times, telling him that mommy will be busy later on and he can be a good boy playing with some toys after the walks in the stairs. There was no logic to the consequence of possibly letting him fall.

At times, however, children will and should fall. A book that provoked a lot of debate in Sweden problematized the consequences of what was termed “curling parenting”, a Swedish version of alleged overprotective parenting where the path is cleared for children, as the ice is swept clean in the sport of Curling by the Sweepers for the granite stone to glide as smoothly as possible. The authors Carl Lindgren and Frank Lindblad argued that in parents’ efforts to protect their offspring from injuries and negative experiences, the children were left without resilience for the normal challenges of life.

Given the links between overprotective parenting and fearfulness and anxiety in children (Rapee, 2009), they seem to have a point. Of course children who are temperamentally inhibited, less sociable and more fearful of new situations, might elicit this type of parenting when they are toddlers. So the causal pathway could go either way, but being overprotective certainly does not improve these children’s bravery or resilience.

To be honest, I tend to be pretty protective of the children. Helmets, sunscreen, and life vests are non-negotiable and they are all tired of hearing me talk about never going anywhere with strangers. But I like to exercise “controlled risk”, as in letting them walk on their own to the store and back, secretly checking on them or biking behind the bus when they are riding it on their own for the first time to school. I hate letting them go to camp or downtown with friends, but I do, because I figure that is part of being a good parent. And because my husband tells me not to be such a mother hen…

But I have to stop myself from making up all kinds of terrible scenarios in my head and something in me will not settle until the kids are all back and sound asleep in their beds so I can peep in and listen to their even breathing. That will, of course not be like that forever, because we have to let go of our children: the question is only  when and how.

14 years of being who she is

So on this rainy-sunny September day my eldest daughter turned 14. Actually, the fact that it hails like mad outside right now suits her temper quite well. Sometimes it hails both inside and around her. It is much like I used to be, with a ball of fire lighting up in my stomach, shooting out of me, burning people and things in its way. I still throw the occasional bowl, but honestly, I check so it is a plastic one and throw it somewhere where it won’t damage anything. So there is really almost no point left in throwing things around because of all the planning and then the cleaning it takes.

But the temperamental trait, that ball of fire igniting, my reluctance for changes and new situations with lots of new people, and my need for some quiet, own time has stayed the same ever since I was an infant. I was an easy baby though, because my mother understood my needs and the current ideology of a very regular schedule for infants suited my rythmicity perfectly. Five years later, my brother had a hard time teaching my mother that not all babies are the same, but I think she got it after a while.

So when my daughter screams and shouts and gets overwhelmed when we ask more than two things of her at the same time, I have no problems understanding her. My poor husband just looks at me and says: “What wrong did I say now?!” Well, truth is, it’s not just the what; it’s the how, and the timing, and the weather, and the mood for the day that all adds up to ignite that fire or start the hail. But there are not only cons of having an excitable temperament, it also helps you take in the world through all your pores and helps you live more fully. So Fanny can create and play music and photograph beautifully or be absorbed in a book with cutting out the world completely. With experience and a respect for your own needs it is possible to make the best of any kind of temperamental trait. As a parent, your role is to try and accommodate your child’s temperamental needs and teach them how to tame some of the trickier implications of being who they are.

And you might as well start today because temperamental traits are extremely stable over time. The Australian Temperament Project (ATP) followed infants for 30 years. They found three aspects of temperament to be most important and also most stable: “sociability – the tendency of a child to be shy or outgoing in new situations and when meeting new people; reactivity – how strongly a child reacts to experiences and to frustration; and persistence – the extent to which a child can stay on task and control their attention, despite distractions and difficulties” (cited directly from the ATP website). These temperamental aspects also affect the person’s capacity to self-regulate, implying control over their feelings and behaviour, and ability for focused attention that is so important for learning.

The good news is that strong social skills, stable and warm parent and peer relationships, and good school experiences all influence how well children fare. So our job as parents is to help our daughter make the best of her reactivity – focusing on the important things and discarding irrelevant stimuli, to expose her to fun people where she can take advantage of her sociability, and encourage her persistence even on tasks that are not all that fun.

As for the fire and hail – those things will wear off some with time and the people who want to remain close to her will simply learn to duck. Until then, she has discovered that the pillows in the sofa serve her very well when she needs to let off some steam. I might actually try that next time my fire ball comes on, because we don’t have any plastic bowls here.

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It’s not fair

Although our six-year-old has to practice handwriting and using scissors a bit more to produce neater results he knows and uses the term “fine motor skills”. He reads in three languages on grade levels higher then his own.

He could learn to read because he can focus his attention on a certain task and persist until he is done. Sometimes when we play chess and I am ready to give up he’ll tell me: “No, mommy, we’re not done yet, you need to keep thinking!” He gets along well with his peers and makes new friends easily. Although he sometimes bites his older sisters when he is furious, he has the self-control not to use that behaviour at prep. He knows he is loved and is capable of extending his love to others. These skills are essential for children’s academic and social development.

What is not fair is that these vital building stones of human development – focused attention, self-regulation, and a healthy sense of self-worth – are not equally distributed among children. Some enjoy the effects of a nurturing environment, whereas others fall behind early on.

By age five there is a 30 million word-gap between children who belong to the highest and the lowest socioeconomic groups in society in Northern America. So the least advantaged children have been exposed to 30 million less words by their immediate environment, and consequently, the development of their impressive and expressive language skills will lag behind.  Differences in focused attention are huge because the brain is an organ where the rule is use it or lose it.

In countries with no access to universal early childhood education services the social gap – and with it, lost potential – is enormous. In Scandinavia, the preschools serve as a compensatory mechanism and are especially useful for children coming from disadvantaged families. The U.S. has launched a number of successful programs for early childhood education for low-income families, such as Early Head Start. Australia has got some catching up to do in this area!

The excellent book From Neurons to Neighborhoods (Shonkoff and Phillips, eds, 2000) summarises evidence from neuroscience, child development research, and molecular genetics. They shatter the controversy of “nature versus nurture” as a cause of developmental differences by presenting strong evidence that it is both. They make the case that no society can allow itself not to do everything in their might to provide safe, healthy, nurturing, and developing environments to all children.

The importance of the equal distribution of these commodities is described in a book I refer to as our ”bible”: Developmental health and the wealth of nations, edited by Daniel Keating and Clyde Hertzman, 1999. There is a Latin proverb: Nomen est omen – your name predicts what you might become. Hertzman can be translated to The Man of Heart and it is exactly what Clyde was.

I met him at his favourite breakfast place in Vancouver and he generously shared his experiences with me. He stressed the importance of speaking a language that politicians will understand and be able to act upon. Clyde Hertzman died recently, but if you want to see a truly inspiring video where he explains the complex issue of environmental effects on brain development in a simple way, do watch him speak here.
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So what is not fair is that our son is fast asleep in his bed after a dinner with his family and a story read to him, while other children never get a chance to experience that. The tragedy is that so much of the ingredients of suboptimal development, such as insecure attachment, prenatal environmental hazards, chronic life stress, violent relationships, economic disadvantage, and low academic achievement seem to be “inherited” from one generation to the next.

The good news is that even if you are not in a position to make a difference for many children you can always be a significant adult in the life of at least one child – and I don’t mean your own. Children are wired for interaction and learning. So extend your love and attention to a child who needs it: read a story, show them affection, tell them everyone is good at something and the trick is only to find out at what. Show them they are worth loving for just whom they are. That will oil their brain wires for learning and experiencing.

If you are in a position to make a difference: do your part in making high quality early education accessible, affordable, and equitable.

Making amends

Johanna’s ordeal for having broken the school rules is not quite over yet. Of the three steps of designated consequences (which take a lunch recess each) they have gone through steps one and two: understanding and admitting that they had done wrong and telling about it to their parents in writing. The third step is making amends. The girls have to come up with a list of what they might do to make the junior students in year 1 feel safe again. The principal will then select which one of the proposed amends seems most reasonable and organise for the girls to make these amends. We talked to him this morning and he said the girls will probably be placed in the year 1 classroom to help out and thus have a chance to befriend the kids there.

Being able to solve conflicts in a constructive way is a very important life skill. It is not parental conflict per se, but unresolved parental conflict that is detrimental to children’s mental health, social skills, and academic success (Cabrera, 2012). Whether it is icy silence or the banging of doors, unresolved conflict poisons the air of any home. If there is also violence in the family the consequences for children are dire. All sorts of mental health problems, worse academic achievement, being an offender or victim of bullying, and a detrimental internal model of close relationships are clearly associated with children’s experience of domestic violence, even if they themselves are not victims. It is therefore in the best interest of every child to learn acceptable ways of resolving a conflict so they can become responsible adults and parents. The beauty of making amends is that it makes everyone feel better. There is no evidence to support humiliating treatment, such as the “naughty chair” or forcing the child to say “sorry”, when in fact the only thing they can think of is revenge. But making amends can be very empowering.

A lot of adults would be so much better off if they had these life skills. On my walks along our beach promenade I often overhear conversations that reflect the lack of such strategies. “He knew exactly what he was doing and now he has ruined our relationship”, a woman said to her friend while they pushed their prams along the path. “If you are in love you should go to the church and not to the city council”, a young woman cried as she rose and left her (ex?)partner sitting, stunned, on the bench. Many such couples would be doing so much better if they had access to some effective tools.

The Preparation and Relationship Enhancement Program (PREP) developed by Markman, Stanley & Blumberg and described in the book Fighting for your marriage, offers such tools. The concept builds on research that certain behaviours in a couple, namely defensiveness, stubbornness, and withdrawal from interaction, are especially detrimental for the relationship on the long run (Gottman, 1989 ). In PREP couples learn other, more constructive strategies. A skill that many couples remember a long time after they have been to the course (Engsheden, Bokström, Fabian & Sarkadi, 2013) is the speaker-listener technique. In case of the young woman wanting to have their wedding in a church it could have sounded like this with the woman taking responsibility for her own feelings as a start:

–       I feel very strongly that marriage as an expression of real love should happen in a church and not at the city council. As long as I can remember I have dreamed of a beautiful ceremony at the church. I feel upset when I hear you say the city council would be your preference.

In the next step, the partner shows he has listened actively:

–       So marriage in a church is something really important to you and it upsets you when I say that I would prefer just going to the city council.

In the next step, she should acknowledge this and invite him to express his opnion:

–       Exactly, that’s exactly how I feel. So what do you feel about this?

–       Well, I really don’t have any kind of meaningful relationship to the church and for me it feels pretentious to have my wedding there.

It is now her turn to show that she has listened actively:

–       So you don’t have any real connection with the church and it doesn’t feel right for you to marry there because of that.

And on it goes. You may try this at home…