How to “Like” a Child Whose Tough to Live With

Many parents have children who are really hard to spend time with. I know because I see these kids interact with their parents in my office. And—I get an earful from parents who have children of all ages who have serious problems like severe ADHD, bipolar mood disorder, oppositional—defiant disorder, personality disorders and different types of addictions. Parents of children with any of these really struggle communicating positive messages to their kids because they’re just tough to be around. So what’s a parent to do? Are they off the hook when it comes to making sure that their kids feel loved and accepted? Unfortunately, no. Parents need to find a way to cope with their child’s illness AND give the child a sense that they are lovable, likeable people. This is no small feat.

Children who suffer from difficult disorders still have deep feelings and struggle with all of the same issues that otherwise healthy kids do. They, too, need to have a healthy self esteem, to know that their parents love them no matter what and to learn while they are growing up that their parents always accept them. The struggle for parents is twofold. First, how do you cope with bad behaviors and second, how do you communicate to the child that you still love them regardless of those behaviors? These are tricky but I’ve learned a few helpful things over the years by watching some good parents.

First, parents must separate the illness from the child. Many times parents see the child as the problem but when they try to see the child as an individual who lives with an illness, it’s easier for them to love the child. I tell kids with severe hyperactivity that they have something—hyperactivity, bipolar mood disorder, etc., —that has moved into their bodies and we need to get it under control. More importantly, the disorder is not who they are, but something they live with. If we help kids see that they are not their illness, they feel enormous relief. Just as a boy named Justin may have a broken leg who needs a cast, the same boy named Justin might also have bipolar disorder that needs medicalhelp. This technique also helps parents put the blame on the illness, not the child. And when a parent does that, a child feels less like a bad kid. This is very important because problem kids are frequently in trouble and they begin to feel that they are bad and no one ever wants to be with them. This would be a painful way to live.

Second, parents must identify specific behaviors that the child does and name them. They may see: hyperactivity, temper tantrums, outbursts of anger, anxiety or defiance, for example. Once a parent identifies specifically what gets under their skin, then they come up with a coping strategy for that behavior specifically. For instance, if a child is really hyperactive, a parent can come up with a survival plan for bouts of unusual intensity. They can go into another room, make the child spend an hour outside, recruit a high schooler to come help out after school if the child is young. In other words, life feels less stressful once a parent has a plan for dealing with specific tough behaviors, even if they don’t feel completely successful. Having a strategy is very important to a parent’s mental health.

Parents should also watch for patterns of certain behaviors to see if any have a rhythm. This helps them understand that the illness sometimes has a “life of its own.” Anxiety and depression, for example, cycle. A child—even if he is treated for either of these—will have periods of calm and happiness and then out of the blue become irritable, anxious or depressed without prompting. This is simply the rhythm of the illness and if parents can identify it as such, coping with it becomes much easier. They learn to wait the period out rather than scramble and try to figure out what they did wrong, how to fix the problem, etc.

Third, parents need to intentionally find times when they can be with a child and try to communicate love and acceptance. It can be hard on a day to day basis because the child’s behavior is stressful, so it’s important to plan to do it. They can plan a Saturday afternoon bike ride, dinner out together or something else that the child will enjoy. When the time comes, mentally gear up to leave hard feelings at home and make the time as positive as possible. Tell the child a few really positive things about himself during that time. Sometimes a parent may plan a time like this and then the afternoon blows up. If it does, just move on and try another time. Don’t get mad, just try again.

Fourth, parents can write letters. This is very special to all kids and none of us does it enough. The great part of letter writing to a difficult child is that you can write any time and he can read it any time. You don’t have to tell him positive things to his face and have him argue because he can’t argue with a letter.

Fifth, pray for your child and yourself. When parents pray for their kids, remarkable things happen. Prayer allows us to ask God to help out and take over. This invites God to do what He wants with the child and importantly, it changes those who pray. Prayer is profoundly mysterious and it works. It doesn’t unleash our will on our kids through God’s hand; rather it unleashes God’s will and helps us learn to accept it. When this happens, everyone wins. Ask God to give you the strength and patience you need to live with the difficulties. Remember, your child has to live with those same difficulties but doesn’t know how in the world to change them, so let them know that you are praying for her/him. Don’t tell her/him that you want God to change her (she’ll feel terrible about herself) but that you are asking God to help both of you get her difficulty under control.

Finally, never allow the illness to become an excuse for the child. While troubling disorders do interrupt life for kids and their families, the goal for the child is to ultimately learn to take charge of it. Adult children with severe hyperactivity need to be able to own it, treat it and succeed in spite of it. Once we let kids say that they can’t succeed because of their disorder they become crippled. It is a disorder, not the child. When kids begin to understand that they can be in charge of it, that they can succeed with it, they feel more hopeful and a have a much greater chance of success in life.

LuAnne: A Lesson for Every Mother

My friend LuAnne Crane recently made one of the hardest decisions of her life. She decided to leave a job she has loved for 30 years and be home with her high school aged son. For every mother who has lived the tension of working outside the home and caring for children, you know her angst. She loves her kids and wants to keep them as her first priority. But she loves her job and knows that God has gifted her with a passion for it. LuAnne’s situation is unique though. She doesn’t have young children at home. As a matter of fact, three have left home and only one high schooler remains. So why leave a job she is called to and stay home? That’s where we mothers need to pay attention.

LuAnne has realized a truth that many of us mothers with older children miss: our teens need us more than our grade-schoolers. LuAnne sees that her son will be facing some of his toughest challenges yet. His friends may want him to do stupid things. So who will help him? LuAnne. He will need to learn to drive, figure out whether he wants to date, struggle with friends who will drink, smoke weed and take drugs. College is around the corner and he will question himself repeatedly about whether he should go, where he should apply or whether he should work. Id he does apply to college, rejection letter will comes and he will be shaken. Who will hear him as he works through the answers? His Mom.

Here’s the real tough part for LuAnne. She’s in the homestretch with her son. She may wonder, does he really need me? After all, our culture tells her that since her son is now a teen, his life revolves around his peers. Lie number 1. All the best studies on teens report that the number one influence in a teen’s life which keeps them away from trouble is us- their parents. Period.

Then LuAnne will hear that her son won’t want her around, Lie number 2. I have listened to literally thousands of teens over 25 years and can unequivocally state that the greatest pains in teens’ lives stem from fractured relationships with their mothers and fathers. Kids with mothers who take time to listen and love and with fathers who care enough to say “no” have much greater emotional stability. These are the kids who fly in life. Since she will be there, LuAnne’s son will stand a much better chance for succeeding after he leaves home.

LuAnne gets this. Leaving a post where she is admired, appreciated and loved is tough stuff. In the next months, the payoff won’t be immediate. As a matter of fact, the next three years may be grueling for her, depending upon her son’s struggles. But I can guarantee her one thing: the payoff will come. For her and for her son.

Moms, let’s not miss her example of selfless courage. Every one of us has lived with this tension. We want the accolades, the money, and the excitement that come from a career. But there is a price to be paid. When the price is too great for you, remember LuAnne. May each of us live with her kind of courage.

The Boston Tragedy: How to Talk to Kids When Bad Things Happen

In light of the recent Boston tragedies, I feel that it is important that we help our kids process hard information. Often we focus on praying for the victims, talking about what the next move for the government should be and we forget that little eyes are watching and ears are hearing. As disturbing as the Boston chaos has been for us, it can be worse for our children. SO we can’t let them get lost in the shuffle. To that end, I wanted to encourage you parents to reach out to your kids and help them through this difficult time.

If your kids are in elementary school, I suggest doing the following:

1. Initiate conversation. Don’t wait until they come to you. Kids are listening to the television and to their friends talking so they are thinking about the bombings. Initiating discussion won’t put ideas or fears in their minds, talking them through will help alleviate their fears.
2. Use simple language. When telling them about the tragedies, you can say that someone who is very disturbed set bombs off on innocent people. Don’t tell gory details but say that people were hurt and many are in the hospital.
3. Talk about good and bad. It’s good to tell kids that there is evil in the world and people who do very bad things. You can’t sugar-coat this. However, tell them that there are far more good people. Talk to them about all of the thousands of folks who ran to help the victims and the others who opened their homes to house those who were stranded.
4. Give them something to do. I always tell my kids to pray for those who are in trouble. Even young children need to participate in a solution. Asking them to pray helps them feel that they can make a difference. Also, this helps strengthen their own faith and helps them learn to pray reflexively when life gets tough.
5. Give them reassurance. Tell your children that the chances of things like this happening to them are extremely small. That’s the truth. Children may have nightmares and worry about someone coming to your home and setting a bomb. SO, tell them that your job as Mom and Dad is to protect them and that you feel very confident in your abilities to do your job well. Finally, it’s important to tell them that God sees everything and He will help them. If they question why God didn’t help the people who died simply state that you don’t understand.

If your Kids are in Junior High or High school:

1. Initiate asking about their thoughts. By asking your kids about the bombings, you give them the freedom to express their worries and fears. All kids get scared- even the tough ones and worry about something like this happening to them. So take the initiative to talk about the events and work hard a t listening. If your kids don’t want to talk at first, don’t push; just reopen the conversation a few days later with something like “What are your friends saying about the Boston tragedy?”
2. Broaden the scope of the conversation. When talking about violent people, make sure to discuss reasons why people commit violence. You can talk about mental illness, evil or different religious convictions people may have. Then, discuss that most people don’t do this. Talk about those who helped the victims and the kindness of others. If they want answers as to why bad things like this happen, tell them that you don’t understand. Don’t feel the need to be able to explain such violence.
3. Give them something to do. As with younger children, it is important to give kids a way to help. Encourage them to pray, send letters of support or join with others who are already offering assistance. It is important that older kids feel connected in some way if they want to.
4. Help allay fears. Many older kids become frightened that the world is growing more violent and they become very down about it. While random violence is increasing, it is important to continue to give kids hope. It is helpful to tell them that the chances of this type of violence striking them is still small but that coming together as a community is important in trying to solve these issues.
5. Don’t Preach. As tempting as it is to begin telling our kids why bad things happen from a spiritual or political standpoint, on the heels of a tragedy, the best thing to do is simply diffuse anxiety. You can always talk about your beliefs about spiritual or political issues as they relate to the tragedy later and this will help your kids listen more. If you do this too quickly, they will tune you out.

Who Wants to Care for Melissa Harris-Perry’s Children? Apparently They Don’t Belong to Her

I don’t really know if MSNBC commentator Melissa Harris Perry has kids, but if she does, they might feel confused. The outspoken Perry recently told viewers that children should not be “privatized” rather, she states, children belong “to the community.” Huh?

First of all, children are not commodities or organizations to be made private or public so this notion is absurd from the outset. Secondly, I think that she’s misstating what she really means to assert: that children should be cared for less by their parents and more by the government. That would have been more accurate but would not have sat as well with listeners. After all, assuming full responsibility of ones offspring is one of the most primitive and fundamental instincts of human beings. Mothers are protective, nurturing, and tuned into providing everything from nourishment to love for their children. To state that someone other than a mother (or father) can compete with these instincts is ridiculous.

But I get what Ms. Perry wants. She wants the government to assume care for our children because she and her ilk don’t believe that parents are doing a good enough job. Consider the recent Federal Court decision to release age restrictions on kids who can buy Plan B. Here is a perfect example of the government “caring” for kids because their parents are too ignorant, mean or unaccepting of teen behavior. In this case, I can tell you as a pediatrician who has cared for many sexually active teens over the years, this decision is just plain bad medicine and furthermore, when a child is 13, avoiding pregnancy is just the beginning of her problems if she needs Plan B. Who will care for her mental state, infections she will likely get or the emotional upheaval of having sexual partners (who, statistically will probably be much older than she is?)

Ms Perry’s statement is one more pitch to have the government get on parents’ way, And this makes me mad0 both as a mother and a pediatrician. Research shows unequivocally that parents are the most powerful influence in a child’s life when it comes to keeping them out of trouble and helping them succeed. Does she not read the research?

I encourage you parents who want to keep control over the decisions made about your kids to stay on guard. When the government threatens to wedge its influence between you and your kids, don’t allow it. Make you voice heard and make it loud.

P.S. - If you haven't you seen the recent ad from Melissa Harris-Perry of MSNBC News click here. It’s made its rounds through social media, drawing criticism from parents and others.

My 7-year-old Is Wetting the Bed Again

I recently heard from a mother who has a seven-year-old son who is having issues with bedwetting. She says that her son potty trained at three and wore Pull-ups® at night until he was about five. Finally, he was dry all night long for two years. Then, out of the blue, he started wetting the bed. She is wondering if this is normal or if she should take her son to the pediatrician.

Most parents know that boys take longer to potty train than girls. The average age for daytime dryness for boys is three years old. That means there are some boys who are 2 ½ years old and others who are 3 ½ years old who are still working on using the toilet. The process can be painfully slow for parents but it is important to be patient because boys don’t have control over their bladders until they are older.

Most boys don’t stay dry all night long until they are closer to 4 years old. This mother’s son was within the normal range for nighttime dryness. Once boys stay dry at night, they usually don’t regress. Her son, however, did regress and she wants to know what’s up.

Enuresis is the term used for wetting. Children can have daytime enuresis or nighttime enuresis, and the causes can be different. When a child never stays dry during the day or night, he has primary enuresis. This is quite common. In fact, 16% of five-year-olds, 13% of six-year-olds and 5% of ten-year-olds have primary enuresis.

If, however, a child potty trains completely and stays dry for a period of time and then begins wetting again, he has secondary enuresis, as this mother’s son had.

Many different things can cause secondary enuresis and below are some of the most common:

• Urinary tract infection – It is important to go to the doctor and get a urinalysis on your child to see if there is any sign of infection.

• Overactive bladder – Often enuresis is caused by a bladder muscle which is overactive. There are exercises and medication that can help with this.

• Constipation – Often children who have chronic constipation will get urinary tract infections and this will cause daytime or nighttime wetting

• Disturbed sleep – If children have poor sleep quality (sleep apnea, snoring, etc.), they can experience enuresis.

• Underlying medical problems like thyroid disease, diabetes or sickle cell disease. These are problems that your physician would detect.

• Neurological injury – If a child has had an injury to the nervous system, this can cause enuresis.

• Trauma – If a child has been traumatized by abuse (particularly sexual abuse) enuresis can occur.

If a child has been dry for a long period and then begins wetting, it is important to take him to the pediatrician for a thorough physical exam and preliminary evaluation for other problems. Once the cause has been found, it can be adequately treated. Sometimes, however, no cause is found and the child simply needs help retraining.