What's Going On With My Kid?
“there’s something goin’ on here and you don’t know what it is…” Bob Dylan When I was growing up and listening to Bob Dylan, I didn’t know any kids being diagnosed with ADHD, ODD, and Bipolar disease. They weren’t given serotonin reuptake inhibitors for depression or administered mood stabilizers to manage extreme moods and behaviors. LD or Learning Disabilities didn’t become actual classification until the 1970′s when congress passed IDEA-PL92-142 (Individual’s with Disabilities Act) and IEP’s (Individualized Education Plans) became law to help children experiencing significant problems in the classroom. Nonverbal Learning Disorder (NLD) or Aspergers syndrome weren’t even part of the lexicon. The truth of the matter is, however, all the child problem’s that exist today DID exist back in the 1950′s and 1960′s (and before). LD and ADHD used to be referred to as minimal brain damage and hyperkinesis. Children were medicated, but it was significantly less. Educational support was available, but not necessarily in the school. Children with severe NLD or Aspergers were often misdiagnosed as schizophrenic or autistic and sent away to institutions.
With progress and change, many wonderful tools have become available to parents and child advocates that have allowed society to better assess and treat children with problems. Consequently, many more children are being diagnosed with problems and the cost to treat them has risen astronomically. With progress and change, the landscape of childhood and adolescence has evolved. In addition to all the psychological and sociological shifts or changes there are biological ones as well. For example, the literature reports the onset of menstruation for girls today is earlier than 50 years ago. Moreover, the dramatic effect of divorce on children, the daunting influence of media on eating disorders and steroid use, and teen suicide occurring at alarming rates are further examples of how society has impacted the mental health of our children. So… I ask the question “what’s going on with my kid?” as a rhetorical remark to challenge parents to become knowledgeable about the variations in child development and how to assess whether or not your child needs help.
In order for a parent to determine whether or not his or her child has a problem, it is important to view children from a developmental perspective. When Psychologists refer to normal child development, they expect a sequence of physical, biological, psychological, and socio-emotional patterns to emerge over time as the child matures into adulthood. There are many developmental principles that define child development. Below are three principles that help give a flavor of developmental theory:
- Development is sequential and predictable. Despite the myriad of changes children experience, development is rather orderly and unfolds in a predictable sequence. For example, an 8 year old child views the world concretely, things are either black or white, good or bad; a teenager, however, possesses the ability to abstract and the world perspective turns to gradations of gray.
- Developmental skills begin in a simple fashion and proceed in an orderly fashion toward a more complex structure. Language development is a perfect example of this where sounds and babbling give way to words, sentences and stories.
- The biology of the child places limits on the child’s development. Biology refers to how a human being is ‘wired’. Let’s say a child is unable to read or is dyslexic, it can effect how a child establishes an academic foundation to learn.
Problems in child development occur when the usual sequence fails or the child lags by comparison to similar aged peers. When a child is unable to meet the tasks in a particular stage, he or she will not be as well equipped to meet the tasks and challenges ahead. The proverbial ” stuck in his adolescence” is a reference to an adult unable to meet the challenges of being a mature productive adult because he has not mastered and resolved the tasks of adolescence. Parents need to understand normal child development before they can appropriately determine problems or abnormalities.
It is true that children today are diagnosed with psychiatric disorders at a much higher rate than 2-3 decades ago. Does that mean children today are more disturbed or “sicker” than the generations that preceded them? Or conversely, are we over diagnosing normal children with psychiatric diagnoses and falsely creating a generation of mentally ill children? There is no simple answer and the problem is not so black and white. Regardless of where one stands philosophically on the childhood mental illness issue, parents need to be able to determine when their child is experiencing problems that negatively affect normal development. My professional preference is to view children through “the facts of their experiences” and then place that in a developmental framework. I steer away from labeling problems as illness and work toward helping children capitalize on their identified strengths and coping with and/or reducing their identified weaknesses. What are notable problem areas or “the facts of childhood experiences?”
- DISRUPTIVE BEHAVIOR PROBLEMS-These are the ADHD, ODD, Conduct Disorder type children who experience problems of self-control, self-regulating, and organization.
- MOOD PROBLEMS-Depression and extreme variability of mood are the hallmarks of this category.
- WORRY AND FEAR PROBLEMS- The anxious child or fearful child who is inundated with experiences of ‘fight or flight’.
- LEARNING PROBLEMS-Children who experience the learning process as a chore and age-appropriate skills are not easily assimilated.
- RELATIONSHIP PROBLEMS-This problem area refers to attachment difficulties and problems in establishing and maintaining healthy social relationships.
- PROBLEMS IN DEVELOPMENT- When children experience significant problems in normal development across all of the above mentioned problem areas. Today, these children are often referred to as PDD, or suffering from pervasive developmental disorder.
The problem areas listed above are a guideline to help parents conceptualize how their children experience difficulties in their lives. The six categories are not mutually exclusive; overlap is common and often the case. When parents believe problems are present and are outside the normal realm of child development, they must determine the 1.) Duration, 2.) Frequency and 3.) Severity of the problem area. If a child is exhibiting problems for more than a month, on a frequent basis, and it is interfering with normal expected tasks, then parental intervention is indicated. Clearly, professional help is advised, but is best received by the child when parents have done their homework.
I sincerely doubt that Dylan was addressing parenting issues when he wrote “Ballad of a Thin Man.” In fact, the allegory takes place in a creepy masquerade of confusion and mirrors. The echo “something is happening here and you don’t know what it is” is a universal chant of being lost when you are suppose to know what is going on. A parent’s challenge is to bring rays of hope into the home when his or her child’s despair seems so strong. I will conclude this newsletter with another Dylan verse, one of hope for our children:
May God bless and keep you always
May your wishes all come true
May you always do for others
And let others do for you.
May you build a ladder to the stars
And climb on every rung.
And may you stay forever young.